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Meal Plan Change Request

General Information
Please provide the following general information. Information in bold is required.
Student's first name	Student's last name	Student's MI
E-mail address
Extension/Phone
Student ID
Room Number Type COM if commuter
Semester	Fall 2012

Meal Plan Change Request
Please provide this information only if you are selecting a meal plan other than the one listed on your Statement of Account. Your tuition account will be charged accordingly.

Bon Appetit Bock Meal Plans	Kosher Block Meal Plans
190 Block Plan (190 meals + $300 Dining Dollars) $2395 150 Block Plan (150 meals + $350 Dining Dollars) $2166 140 Block Plan (140 meals + $325 Dining Dollars) $2114 120 Block Plan (120 meals + $300 Dining Dollars) $2070 100 Block Plan (100 meals + $300 Dining Dollars) $1714 Off-Campus 50 Block Plan (50 meals + $50 Dining Dollars) $840 (Available to commuter students only) No Meal Plan $0 (Available to commuter students only)	Kosher 190 Block Plan (190 meals + $300 Dining Dollars) $2644 Kosher 150 Block Plan (150 meals + $350 Dining Dollars) $2422 Kosher 140 Block Plan (140 meals + $325 Dining Dollars) $2308 Kosher 120 Block Plan (120 meals + $300 Dining Dollars) $2236 Kosher 100 Block Plan (100 meals + $300 Dining Dollars) $1875 Kosher Off-Campus 50 Block Plan (50 meals + $50 Dining Dollars) $920 (Available to commuter students only) Additional Passover Plan $200