Application for in-State Residency Status-Short Form Active Duty & Veteran - University at Buffalo - Buffalo, New York

ADVERTISEMENT
Application for In-State Residency Status-
Short Form Active Duty & Veteran
Return form to: Student Accounts
University at Buffalo
232 Capen Hall
Buffalo, NY 14260
Phone: 716-645-1800 Fax: 716-645-7771
Email:
UBstudentaccounts@buffalo.edu
Section A - Personal Information
Semester applying for:__________ UB Email:__________
Last Name:____________________ First Name:_____________
Middle initial:_____
Citizenship: US citizen_____ Other_____ If other, list Visa type:_________
If you are a Permanent Resident list your Alien Registration Number:_____________
Date issued:_____
Did you attend a NYS high school or an approved NYS program for General Equivalency Diploma (GED)
examination within 5 years of applying to the University?__________________________
U.S. Military Veterans
At any time (past or present) were you, your parent or spouse eligible for VA educational benefits? Yes_____
No_____
If yes, please continue to Section C and submit required documents along with this form.
Section B - Active Duty
Are you, your parent or spouse a member of the US Armed Forces on Active Duty?
Yes_____ No_____
Is the current duty station in New York State?
Yes_____ No_____
If you answered no, are you stationed outside of NYS with at least 90 days of aggregate
service time?
Yes_____ No_____
If no, you are ineligible for in-state tuition rates. **
If your parent or spouse is stationed outside of NYS you are ineligible
for in-state tuition. **
Please continue to Section D and submit required documents along with this form.
** If you, your parent or spouse is a member of the US Armed Forces on active duty with a
Home of Record in NYS please continue to Section D and submit required documents
along with this form
Reserve and National Guard
Have you completed Initial Active Duty for Training?
Yes_____ No_____
If yes, continue to Section D and provide required
documents If no, you are ineligible for in-state tuition rates
Last updated: 1/2017
Page 1 of 2
Application for In-State Residency Status-
Short Form Active Duty & Veteran
Return form to: Student Accounts
University at Buffalo
232 Capen Hall
Buffalo, NY 14260
Phone: 716-645-1800 Fax: 716-645-7771
Email:
UBstudentaccounts@buffalo.edu
Section A - Personal Information
Semester applying for:__________ UB Email:__________
Last Name:____________________ First Name:_____________
Middle initial:_____
Citizenship: US citizen_____ Other_____ If other, list Visa type:_________
If you are a Permanent Resident list your Alien Registration Number:_____________
Date issued:_____
Did you attend a NYS high school or an approved NYS program for General Equivalency Diploma (GED)
examination within 5 years of applying to the University?__________________________
U.S. Military Veterans
At any time (past or present) were you, your parent or spouse eligible for VA educational benefits? Yes_____
No_____
If yes, please continue to Section C and submit required documents along with this form.
Section B - Active Duty
Are you, your parent or spouse a member of the US Armed Forces on Active Duty?
Yes_____ No_____
Is the current duty station in New York State?
Yes_____ No_____
If you answered no, are you stationed outside of NYS with at least 90 days of aggregate
service time?
Yes_____ No_____
If no, you are ineligible for in-state tuition rates. **
If your parent or spouse is stationed outside of NYS you are ineligible
for in-state tuition. **
Please continue to Section D and submit required documents along with this form.
** If you, your parent or spouse is a member of the US Armed Forces on active duty with a
Home of Record in NYS please continue to Section D and submit required documents
along with this form
Reserve and National Guard
Have you completed Initial Active Duty for Training?
Yes_____ No_____
If yes, continue to Section D and provide required
documents If no, you are ineligible for in-state tuition rates
Last updated: 1/2017
Page 1 of 2
Section C: Required Documents for Veteran/Dependent of Veteran
Where applicant for in state
Where applicant for in state
Where applicant for in state
(A clear copy of the
status is the Student
status is the Spouse
status is the Dependent
documents listed below
Child
must be enclosed with the
application for Residency
for Tuition Purposes)
x
x
x
Veterans DD Form 214
x
x
x
Proof of Benefits *
Driver’s License
x
x
x
Marriage Certificate
x
Birth Certificate
x
*If the honorably discharged veteran is receiving benefits, please provide documentation (i.e... Certificate of Eligibility)
Section D: Required Documents for Active Duty, Reserve and National Guard
Where applicant for
Where applicant for in state
Where applicant for in
(A clear copy of the documents
in state status is the
status is the Spouse
state status is the
listed below must be enclosed
with the application for Residency
Student
Dependent Child
for Tuition Purposes)
Military orders or Home of Record
x
x
x
Driver’s License
x
x
x
x
Marriage Certificate
Birth Certificate
x
Last updated: 1/2017
Page 2 of 2

Download Application for in-State Residency Status-Short Form Active Duty & Veteran - University at Buffalo - Buffalo, New York

354 times
Rate
4.8(4.8 / 5) 25 votes
ADVERTISEMENT
Page of 2