* This form must be submitted by the priority deadline to ensure a determination of eligibility before the Fee Due Date. Students may still apply
for aid after the priority deadlines, but EFSC cannot guarantee that late submissions will be notified of aid eligibility prior to the Fee Due Date.
2019-20 Selective Service Form
The Selective Service System has not confirmed your registration or exemption status. You must provide Eastern Florida
State College verification of your selective service registration status to determine eligibility for federal student aid.
Priority Deadlines*: Fall 2019 – 07/18/19 | Spring 2020 – 11/25/19 | Summer 2020 – 04/23/20
A. Student Information
Last Name First Name M.I. Student ID
B. Selective Service Registration Status
Please select the appropriate status and provide any documentation listed.
☐ I am required to register and have not yet done so. I understand that I am not eligible for federal student aid
until I register. Registration is available online at www.sss.gov or by completing a Selective Service registration
form at your local post office.
☐ I am registered with Selective Service. My Selective Service Confirmation # is .
☐ I am not registered, but I have received a status information letter from Selective Service.
• Attach a copy of your status information letter. Visit www.sss.gov or call 1-847-688-6888 to obtain a
status information letter
. If your status information letter states that you were required to register but
failed to do so, please attach an explanation of why you did not register.
☐ I am currently in the U.S. Armed Forces and on active duty (this exception does not apply to members of the
Reserve and National Guard who are not on active duty).
• Attach a letter from your commanding officer documenting your active duty status.
☐ I am a veteran of active duty in the U.S. Armed Forces (excluding National Guard and Reserves).
• Attach a copy of your letter of discharge (DD-214). If you need to obtain a copy of your DD-214, request
it online at www.archives.gov/veterans/military-service-records/ from the National Archives Veteran
Service Records or by calling the Veterans Administration at 1-800-827-1000.
☐ I was born before January 1, 1960.
☐ I am not yet 18 years of age.
☐ I was born female and not required to register.
• Attach a copy of your Birth Certificate.
☐ I am a citizen of one of the following: Republic of Palau, Republic of the Marshall Islands, or the Federated States
☐ I am or was a noncitizen who first entered the U.S. after I turned 26 and I am not required to register.
• Attach documentation of your immigration entry date into the U.S. from ONE of the following:
• I-94 form
• Dated passport immigration stamp entry documenting when you immigrated to the U.S.
• Letter from the U.S. Citizenship and Immigration Services (USCIS) indicating your entry date