Internal Use Only Hall Extenders Form

This form can be used for any extensions into the summer period, authorised or unauthorised, term-time students or Stay guests.

* Indicates required information

Terms of the Extension* This is an extension for a:* If other, please state the student's contract length Room Details* Customer Name* Student Number (if applicable) Kx Reference Number (if available) Initial Check Out Date* New Agreed Check Out Date (if applicable) There is currently no agreed check out date as this customer has overstayed and is bed blocking/needs to check out urgently (Please also call us on 8922 in this case to ensure this is picked up urgently).

Extension Agreed By/Form Completed By* IS this extension by agreement with the customer? Notes