Smoking Agreement Form

IMPORTANT: Only those students living in East Campus are able to smoke in individual rooms in areas of the building where smoking is permitted if an agreement is made via the form below. Students living in Baker House, Burton Conner, MacGregor House, Maseeh Hall, McCormick Hall, New House, Next House, Random Hall, Simmons Hall, and all graduate residence halls, are prohibited from smoking in any area of these buildings.
Beginning in the fall of 2019, all residence halls will be smoke free. For more information, please review the smoking policy at
Personal Information
Room Information
Roommate #1
Roommate #2
Roommate #3
Roommate #4
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