2021 - 2022 Rensselaer Student Dining Plan Cancellation Form

Rensselaer Auxiliary Services

Dining Plan Cancellation 2021 - 2022

Please use this form to cancel your dining plan for the 2021 - 2022 academic year.

Students may cancel their dining plans only if their requests are received within seven business days of the effective semester dining plan start date.  Cancellations will not be accepted after this date unless you are leaving Rensselaer, in which case you can complete this form to cancel your meal plan.

Also please note that residential students (first- and second-year students, and RAs) CANNOT cancel their dining plans.

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Date:
Class year (select one):
First name:
Last name:
Rensselaer ID number (RIN):
E-mail address:
Campus / local address:
Room / apartment #:
Phone number:
Please indicate the appropriate semester:
Please cancel my: (select one)
Please enter the reason you wish to cancel your current dining plan:
Electronic signature (PLEASE PRINT FULL NAME)
By entering my name below, I acknowledge that I wish to cancel my Rensselaer meal plan.
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