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Rensselaer Student Summer 2015 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:
* Please select your desired dining plan: 15 on-demand meals @ $110/week
19 on-demand meals @ $137/week
21 on-demand meals @ $148/week
100 meal block @ $675/block
No meal plan

Meal plans will be available for each of the following weeks; please consider your dining needs for the entire summer when making your selections. Note the specific number for each week, as indicated inside the parentheses.

(1) May 25-May 31 | (2) June 1-June 7 | (3) June 8-June 14 | (4) June 15-June 21

(5) June 22-June 28 | (6) June 29-July 5 | (7) July 6-July 12 | (8) July 13-July 19

(9) July 20-July 26 | (10) July 27-August 2 | (11) August 3-August 9 | (12) August 10-August 14

* Please enter the weeks (by number, as indicated above) that you will require this meal plan.
Please enter all week numbers that apply.

Dining plans: Meal plan service will begin with breakfast on Monday, May 25 and continue through Friday, August 14 in Russell Sage Dining Hall.

Dining plan cancellations: No penalty for written cancellations by Auxiliary Services by Monday, May 25, 2015.

Dining plan changes: No penalties for written change requests received by Auxiliary Services no later than Friday, May 30, 2015.



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)