Graduation Application Withdrawal Form

Graduation Application- Withdrawal Form
Student Name*

First NameLast Name
Student ID Number*
Please enter your student ID number not your social security number or NetID. Your ID number is a 9 digit number beginning with 00.
Email Address*

Confirmation EmailPlease use your @albany.edu email address.
Phone Number*
Please enter a valid phone number.
Program Level*

UndergraduateGraduate
Graduate Degree or Certificate*
Undergraduate Degree or Certificate*
Major/Program*
Semester/Term*

Winter (January) *available beginning 2019Spring (May)Summer (August)Fall (December)
Year*
By signing your name (typing your legal name) below, you acknowledge and certify that all information is correct, you are the student submitting this form, and authorize our office to withdraw your graduation application for the term listed above.

You will receive an email receipt of your request after hitting the submit button. Once your withdrawal is processed, you will receive a confirmation email. Your confirmation email will contain information about how to apply for graduation for past, current, or future terms.
Student Signature*
Please type your full legal name
Processed
Reason Not Processed
Processed by:
Email
example@example.com
Should be Empty:

Graduation Application- Withdrawal Form