|
Name |
| Last:__________________________ First:________________ Middle: _____________ |
| Social Security # ________________ Telephone # (____)___________________ |
|
Address |
| Home:________________________________________________________________ |
| City ______________________________________ State __________ Zip ________ |
| Meal Plan Selection |
| [ ] Meal Plan A / Unlimited access to the Mustang Dining Hall - 319 meals served during a semester. |
| [ ] Meal Plan B / 240 entrances to the Mustang Dining Hall throughout the semester. |
| [ ] Meal Plan C / 80 entrances to the Mustang Dining Hall (available for students residing in Regents Row and Muir Heights as well as students who reside off campus. |
I understand and agree to all terms and conditions regarding the purchase and use of a Campus Dining Services meal plan. I further understand that once chosen and my student account charged, I can not change to a higher or lower meal plan until the next contracted semester.
Student's Signature___________________________________ Date signed_____________________
| FOR OFFICE USE ONLY
Date Received__________________ Date Account Charged_______________ Staff___________________ |