Lease Cancellation/Buyout Form

Name(Required)
I am requesting to be released from my UA Little Rock Campus Living and Dining Lease Agreement and acknowledge that by submitting this Cancellation/Buyout form, I am cancelling my current and future housing applications or assignments.(Required)
I am requesting to be released from my UA Little Rock Campus Living and Dining Lease Agreement and acknowledge that by submitting this Cancellation/Buyout form, I am cancelling my current and future housing applications or assignments.
By signing below, I agree to all terms described above. A new housing application with an application fee must be submitted to reapply for campus housing after submission of this form.(Required)
By signing below, I agree to all terms described above. A new housing application with an application fee must be submitted to reapply for campus housing after submission of this form.
Date(Required)