Fort Valley State University Office of Residential Life 1005 State University Drive Fort Valley, GA 31030 A State and Land Grant University University System of Georgia Meal Assignment Request/Change Form FY2019-2020 INSTRUCTIONS: Students residing in the Wildcat Commons have the option to choose between Wildcat Silver, Wildcat Gold, and Wildcat Platinum meal plans The Wildcat Blue plan is only available for students residing in WC#1 and WC#2 Apartments Requests for an alternate meal plan are to be recommended by the Office of the VP for Student Success and Enrollment Management and approved by the VP for Business and Finance The meal plan adjustment will be made to the student’s account by the Office of Residential Life upon approval All meal-plan meals must be used in the semester for which the plan is purchased and are not transferrable All meal plan requests must be submitted to the Office of Residential Life Student Name: Student ID #: _ Phone Number: _Email: _ Please Print I wish to receive this plan for: _ BOTH Fall 2019/Spring 2020 I live _ Off Campus _ Fall 2019 ONLY _ Spring 2020 ONLY _ On Campus Meal Plan Request (Check One): Wildcat Blue plus $100 Wildcat Gold plus $200 $1310 $1930 Wildcat Silver plus $150 Wildcat Platinum plus $250 $1881 $1968 OFF CAMPUS STUDENTS ONLY Any 75 Meals ($409) _ Any 50 Meals ($306) _ Any 25 Meals ($171) _ Student Signature: Date: _ DO NOT WRITE BELOW THIS LINE RECOMMENDED APPROVED PROCESSED Student Affairs _ Business & Finance Occupancy Management Date: Date: Date: