Request for Exemption from Residency Requirement

Currently enrolled students

Exemption Applied for:
(Please write academic year here e.g. Fall 2019 )


Personal Information

Local Address for Academic Year

Part One: Reason for Exemption Request

I am requesting an exemption for Wentworth’s housing requirement for first- and second-year students. I have obtained the appropriate signatures verifying the authenticity of my request and have attached the appropriate documentation that supports my qualifying factor.

Part Two:

I have provided supporting documentation for my request if noted. I am aware that a committee will review this request and the committee’s decision to approve or deny this request is binding.  

For any documentation containing personal identifying information (birth certificate, marriage license, FAFSA, or tax forms) please do not upload them with this form.  Please email those documents directly to for consideration.”

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx ppt.