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Rensselaer Student Summer 2014 Dining Plan Agreement

Rensselaer Auxiliary Services

Please use this form to request your desired dining plan for the upcoming summer semester.

* Date:
* Class year: (select one)
* Last name:
* First name:
* Rensselaer ID Number (RIN):
* E-mail address:
* Local address:
* Room/apartment #:
* Phone number:

Dining plan options

Note that all options are based on BLOCK meals, which may be used any time the dining hall is open during the summer. Each block is a one-time purchase and does not renew automatically. Please consider your dining needs for the entire summer when selecting a block.

* Please select your desired dining plan: 200 meal block at $1,380
100 meal block at $670
21 meal block at $144 **
19 meal block at $133 **
No meal plan
** If you selected either the 19- or 21-meal block plan above, please specify the total number
of blocks you wish to purchase:
* Please enter the range of the dates you will require this meal plan:
(for example, June 2, 2014 - July 25, 2014)

Dining plans: Meal plan service will begin with breakfast on Monday, May 19 and continue through Friday, August 8 in Russell Sage Dining Hall.

Dining plan cancellations: No penalty for written cancellations by Auxiliary Services by Monday, May 19, 2014.

Dining plan changes: No penalties for written change requests received by Auxiliary Services no later than Friday, May 23, 2014.



By entering my name below, I acknowledge that I understand the terms and conditions regarding Rensselaer's summer meal plan.

* Electronic signature (PLEASE PRINT FULL NAME)