Fillable SUNY Potsdam Residence Life COVID-19 Housing Release for (State University of New York College at Potsdam)

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SUNY Potsdam Residence Life COVID-19 Housing Release for (State University of New York College at Potsdam)

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The SUNY Potsdam Residence Life COVID-19 Housing Release for (State University of New York College at Potsdam) form is 1 page long and contains:

  • 2 signatures
  • 8 check-boxes
  • 14 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State University of New York College at Potsdam

BROWSE STATE UNIVERSITY OF NEW YORK COLLEGE AT POTSDAM FORMS

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RG (07/09/2020)
EMAIL CONFIRMATION:
PACES:
TSAAREV:
SPACMNT:
SLARMAP:
DATE:
DENIED
APPROVED
RESIDENCE LIFE DECISION:
BY (PRINT):
DATE RECEIVED
FOR OFFICE USE ONLY
SUNY Potsdam Residence Life
COVID-19 Housing Release for Fall 2020
This release application is for new and returning residential students who have health concerns related to
living on campus during the Fall 2020 semester due to COVID-19. If approved, students who fill this out and
include all required information will be released to live at their legal home address for the Fall 2020 semester
only and will gain one semester credited to their on-campus housing semester balance. Students approved
for this release will not be charged a termination fee.
P#:
Email Address:
@potsdam.edu
New First Year Student
New Transfer Student
Returning Student
Name:
Cell Phone:
Student Status (select one):
Home Address:
PLEASE INITIAL NEXT TO EACH SELECTION BELOW
I am requesting permission to be released from the housing requirement and to live at home at my legal
address as I will be participating in online education for the
Fall 2020 semester
due to COVID-19 and will not be
physically in Potsdam.
I understand that my parent/guardian must also send a letter or email confirming that I will be remaining at
home. This letter will
include my name, date of birth, and the physical address of our residence, not a PO
box. I understand that an email confirmation will be sent to my Potsdam email address with approval once
all parts have been received.
I am requesting permission to be released from my PACES meal selection as I will be living at home at my
legal
address and will not be on campus nor physically in Potsdam during the
Fall 2020 semester
.
Signature:
Date:
RETURN THIS FORM VIA EMAIL TO RESLIFE@POTSDAM.EDU
FOR QUESTIONS OR CONCERNS, PLEASE EMAIL OR CALL 315-267-2350
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SUNY Potsdam Residence Life COVID-19 Housing Release for (State University of New York College at Potsdam)

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Completed 24 July 2020

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