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Please
print/complete this form and deliver or mail to the DukeCard Office
(100 West Union Building, Box 90911, Durham NC 27708)
DINING PLAN CHANGE
REQUEST
CHANGE:
From
To
MOVING OFF CAMPUS
MOVING TO CENTRAL CAMPUS
CHANGE PERIOD
APPROVED CHANGE
MOVING TO EAST
MOVING TO WEST
DUAA |
CLOSE:
DECEMBER GRADUATE
WITHDRAWAL
LEAVE OF ABSENCE
UPON REQUEST
|
Request Effective:
___________________ Signature: __________________________________
OFFICE
USE ONLY:
BOARD PLAN CREDIT/DEBIT AMOUNT:
POINTS PLAN CREDIT/DEBIT AMOUNT:
CHANGE FEE: ENDING
BALANCE:
|
BILLED IN
DUCC
TRANSFER
COMPLETED |
DATE:
TIME:
OPERATOR:
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Return to Dining
Plans
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