EmailMeForm
Online Housing & Dining Appeal Form
Rice University Students or Organizations may use this form to appeal charges made to their account by Housing & Dining. Please fill in all of the required fields and state your case in a clear and concise narrative.
Name
*
First
Last
Rice ID #
*
Email
*
Phone
*
###
-
###
-
####
College Affiliation
*
Choose college
Baker
Brown
Duncan
Hanszen
Jones
Lovett
Martel
McMurtry
Sid Richardson
Wiess
Will Rice
Status
*
Choose status
Freshman
Sophomore
Junior
Senior
Super Senior
Graduate Student
Date
*
MM
/
DD
/
YYYY
Room # (If Applicable)
Organization (If Applicable)
Are you a student registered with the Student Disability Services?
*
Yes
No
Does this appeal relate to a disability?
*
Yes
No
What are you appealing?
*
*Please be specific and reference a specific work order if applicable.
Detailed description
*
*Please explain in detail your reason for appealing.
Submit letter or document (optional)