Damage Appeal Form

Florida Gulf Coast University

Office of Housing and Residence Life

Damage Appeal Form

Name: *

Date *

Student ID #: *

Phone #: *

Semester Damage Occurred: *

Room number *

Eagle email address *

For all charges you are appealing, please provide a list of what you were assessed damages for and how much you were charged: (ie: Patch and paint small hole in bedroom left wall: $45.00)

Click here to enter text. *

Provide a detailed explanation, citing specific reasons or examples, stating why you are not responsible for the damages charged to your account.

Click here to enter text. *

** This form must be completed and submitted no later than 10 days after the date of your damage letter. Appeals received after that deadline will be considered in the Fall semester after the second week of classes **

Administrative Use

Appeal Denied

Appeal Granted

Charges Reversed on

Emailed student on __________ (date) by __________________ (person)

Date Received:

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