Fill - Free fillable 2020-2021 Selective Service Verication (Clark State Community College) PDF form

Financial Aid

937.328.6034 | ﬁnancialaid@clarkstate.edu | 570 East Leel Lane, Springﬁeld, Ohio 45505

2020-2021

Selective Service Veriﬁcation

Federal law requires men age 18 through 25 to register with the Selective Service System. According

to your free Application for Federal Student Aid (FAFSA), the Department of Education was unable

to verify your Selective Service registration or exemption. You must resolve any conﬂicts regarding

your Selective Service status before being awarded Federal Student Aid.

SECTION A: Student Information

Name____________________________________________ Student ID Number___________________

Address

_____________________________________________________________________________________

Street City State Zip

Home Phone __________________________________ Work Phone _____________________________

SECTION B: Please complete all sections that pertain to your situation.

Part A – Selective Service Registration Conﬁrmation

Please submit supporting documentation including a copy of your registration acknowledgement card,

your web certiﬁcation, or Status Information Letter from the Selective Service. To register or request a

Status Information Letter, go to www.sss.gov.

Part B – Selective Service Exemption

If you are exempt from registering with Selective Service, please select an exception from below.

Please follow all instructions associated with the exemption you select including submitting additional

documents, if necessary.

I was born a female and therefore am not required to register.

I am a male who was born before 1960. Documentation Required: Ocial government-issued

document showing date of birth such as state ID card, driver’s license, passport, or birth

certiﬁcate.

I am currently in the armed services on active duty. Please note: This does not apply to members

of the Reserves and National Guard enlistee who is on active duty for state or training purposes.

I was in the military. Documentation Required: Please attach a copy of your DD214.

I am a resident of the Federated States of Micronesia or the Marshall Islands or a permanent

resident of the Trust Territory of the Paciﬁc Islands (Palau). Documentation Required: Please

provide proof of residency.

I was incarcerated, institutionalized, hospitalized or conﬁned to home from age 18 through 25.

Documentation Required: Attach proof of each instance including dates.

I am a non-citizen male who entered the US after age 26. Documentation Required: Date of entry

stamp in passport, I-94 with date of entry stamp on it, or a letter from the U.S. Citizenship and

Immigration Services (USCIS) indicating the date you entered the United States. If you entered the

U.S. illegally after your 26

birthday, you must provide proof that you were not living in the U.S.

Financial Aid

FAC20SEL

Financial Aid

937.328.6034 | ﬁnancialaid@clarkstate.edu | 570 East Leel Lane, Springﬁeld, Ohio 45505

from age 18 through 25. Please note: Resident Alien Card (Green Card) is not valid as proof of the

date of entry to the United States.

I am/was a non-citizen who entered the US as lawful nonimmigrant on a valid visa and remained

in the U.S. on the terms of that visa until after I turned 26. Documentation Required: For example,

if you entered the United States on an F-1 student visa and remained in that status until your 26th

birthday, you would need to provide documentation indicating that you were admitted on an

F-1 visa and attended school full-time as required. Acceptable documentation for this situation

includes a copy of your I-20 form or a letter from the school(s) you attended indicating your full-

time attendance as a non-immigrant alien. The same requirement applies for all non-immigrant

statuses. Please note: If, at any time, your citizenship status changed before the age of 26, you

may have been required to register with Selective Service. For example, if you were a male who

became an eligible non-citizen on your 23rd birthday and you were no longer on an F-1 student

visa, you were required to register at that time. If this scenario is representative of your situation,

please address your circumstance for not registering in Part C.

Part C – Selective Service Explanation

I did not register with the Selective Service System between the age of 18 and 25. I have attached my

Status Information Letter from the Selective Service. (To request the Status Information Letter please

download the form from www.sss.gov.)

In the section below, please explain your reason for not registering with Selective Service. Attach any

additional documentation that supports your explanation.

_____________________________________________________________________________________

SECTION C: Certiﬁcation Statement

I certify that all of the information on this form and accompanying documents are true and complete

to the best of my knowledge. Furthermore, I arm that I have not knowingly or intentionally provided

any false or fraudulent documentation.

Student Signature ___________________________________________ Date _____________________

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2020-2021 Selective Service Verication (Clark State Community College)

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