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

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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
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