Request Housing Deposit Refund

INSTRUCTIONS: To apply for a Housing Deposit Refund in the amount of $25 (Summer) or $100 (Fall/Spring) complete this form. This form must be submitted by December 1 for the Fall Semester and April 1 for the Spring Semester.

Please don't fill out this input box.

Select Semester*

Summer ($25.00)

Fall ($100.00)

Spring ($100.00)

Student Name*

Student ID*

Mailing Address*

City*

State

Zip Code

Please check*

I understand that if I plan to attend Coahoma, I will have to reapply and resubmit a housing deposit.

Request Housing Deposit Refund

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