Department of Residential Life Housing Release Application

Department of Residential Life Housing Release Application
Name*

First NameLast Name
University ID*
Example: 001234567
Cell Phone*
Please enter a valid phone number.
University Email*
example@albany.edu
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Quad / Apartment*
State Quad Hall*
Dutch Quad Hall*
Colonial Quad Hall*
Indigenous Quad Hall*
Alumni Quad Hall*
Freedom Apartments*
Empire Commons*
L- Liberty Terrace*
Suite/Apartment #*
Bedroom #*
Semester Applying for Release*
Year Applying for Release*
Your Residence License is binding for the FULL academic year. Once you receive your room keys, you are bound to the License. Please note the following criteria to qualify for a release.
Reason for Release*

Withdrawal/ Transfer from the UniversityForeign Exchange StudentStudy AbroadMedical NeedAcademic DismissalInternshipGraduation

Withdrawal/ Transfer from the University
Your first step would be to fill out the online withdrawal form and check that you live on campus. The form can be found here: https://albany.jotform.com/92024199632155

You must also complete this form. Once completed, a copy with approval will be given to you to provide to the quad in which you are moving out of. For a regular (non-medical) refund, you will be refunded a weekly rate up to eight weeks. After eight weeks, there will be no refund. For a medical withdrawal, or a withdrawal beyond your control, you may apply for a weekly rate refund beyond the eight weeks by providing documentation to support this claim.

If you live in Empire Commons, a $400.00 License Termination fee will apply.

Foreign Exchange Student
Foreign exchange students are only accepted for one semester and released from the housing license after that.

Study Abroad
Provide the Department of Residential Life with a copy of your acceptance letter to study abroad. Complete this form, the Housing Release Form, and take a copy of the approved Release Application to your living area office when you return your keys and check out.
Upload Copy of Acceptance letter to Study Abroad*

Cancelof

Medical Need
All medical requests for housing release are reviewed and decided upon by Student Health Services (SHS), Counseling & Psychological Services (CAPS) and/or Disability Access and Inclusion Student Services (DAISS). Requests related to physical medical conditions should be sent to healthforms@albany.edu (Student Health Services). Requests related to psychological conditions should be sent to consultation@albany.edu (Counseling & Psychological Services). Medical requests must be submitted at least four weeks prior to the beginning of the following semester in order to allow time for the gathering of all information. Disability Access and Inclusion Student Services (DAISS) works with Student Health Services (SHS) or Counseling and Psychological Services (CAPS) when making decisions on medical housing releases but these approvals are rare. If your request is approved, please submit a completed Housing Release Form to the Department of Residential Life. Do not send any medical documentation to Residential Life. For more details, please go to the Residential Life webpage under medical need (https://www.albany.edu/residential-life/policies-procedures/housing-release).

If you live in Empire Commons, a $400.00 License Termination fee will apply.

Academic Dismissal
Provide a copy of your academic dismissal letter and also fill out this form, the Housing Release Form. Take a copy of the approved Release Application to your living area office when you return your keys and check out.
Upload Copy of Dismissal Letter*

Cancelof

Internship
(must be at least 50 miles away from the University to qualify for a release.) Must fill out a Housing Release Form and provide proof of Internship. Take a copy of the approved Release Application to your living area office when you return your keys and check out.
Upload Proof of Internship*

Cancelof

Graduation
(Fall Semester only) Complete this form, the Housing Release Form indicating that you are graduating at the end of the semester. Take a copy of the approved Release Application to your living area office when you return your keys and check out. Please note that billing for the Spring semester will go out BEFORE you move out; however, the charges will be taken off of your bill once you move out of your room and turn in your keys. If you live in Empire Commons, a $400.00 License Termination fee will apply. **** Please note that any material found fraudulent will be dealt with by the Community Standards Office.