Page 1
Revised 3/23/2020
Southern Connecticut State University
Application for In-State Tuition
Generally, a st
udent’s residency classification is determined at the time of application for admission.
Any student classified as an out of state resident, who feels that he or she qualifies as a resident of
Connecticut in accordance with Connecticut General Statute 10a-26, may file this application at any
time to request a change of classification.
You may or may not be c
alled for an interview, after which you will receive notification of your
application status. If approved, reclassification will not be retroactive to prior semesters. As a
reminder, all students are subject to the Student Code of Conduct & Statement of Disciplinary
Procedures, which prohibits the act of providing false information to school officials.
STEP ONE: DE
TERMINE YOUR APPLICATION CATEGORY (Please select one):
A You are applying as an emancipated student using your own information. In order to
be an emancipated student, you must be at least 18 years old, you cannot receive regular
financial assistance from parents or guardians, and you must have resided in Connecticut for
at least twelve consecutive months
B You are applying as an unemancipated student using your parental or legal guardian
information. In order to be eligible as an unemancipated student using parental/guardian
information, your parents/guardian have to have resided in Connecticut for at least six
consecutive months and be employed full-time.
C You are applying as a Connecticut resident who attended two years of and graduated
from a Connecticut high-school. In order to be eligible, you must be a Connecticut
resident, have attended two years of a Connecticut high school, graduated from a
Connecticut high school (or the equivalent) and be registered as an entering student at or
enrolled in the University.
D You are applying as an emancipated student using your spouse’s information. In
order to be eligible to receive in-state tuition through your spouse, your spouse has to have
resided in Connecticut for at least six consecutive months and be employed full- time.
E You, your spouse, or a parent (if unemancipated minor) are a member of the military
(1) whose Home of Record is Connecticut;or (2) who is stationed in this state
pursuant to military orders. In order to be eligible as a member of the military, you, your
spouse, or a parent (if unemancipated), have to be stationed in the State of Connecticut
pursuant to military orders.
F You are a veteran, or dependent of a veteran, who resides in Connecticut and was
discharged no more than three years prior to enrollment, and after a period of at least
90 days’ active duty. Please contact the SCSU Veteran Services Office at (203)392-6822
or MordenteG1@SouthernCT.edu
for assistance verifying your eligibility for in-state tuition.
Do not complete this application packet.
Page 2 Revised 3/23/2020
First
Last
Middle
Number & Street (include Apt #)
City State Zip
Southern Connecticut State University
Application for In-State Tuition
STEP TWO: APPLICANT INFORMATION
Name (print) Phone ( ) ______________
Current
Residential Address _________________________________________________________
SCSU Em
ail __________________@southernct.edu
SCSU S
tudent ID Number _______________ Age ______ Date of Birth__________________
What high school(s) did you attend and graduate from (or the equivalent) starting with the
most recent:
School _____________________________________________ Years attended ________________
City, State ______________________________________________ Graduated:
Yes No
School _____________________________________________ Years attended ________________
City, State ______________________________________________ Graduated:
Yes No
School _____________________________________________ Years attended ________________
City, State ______________________________________________ Graduated:
Yes No
When did you e
stablish permanent residency in Connecticut? __________________________
Month/Day/Year
Are you a U.S. citizen?
Yes No
If “no”
, please attach a copy of both sides of your Resident Alien Card, or other documentation
reflecting your visa type or current status, if available.
Page 3 Revised 3/23/2020
First
Last
Middle
Number & Street (include Apt #)
City
State
Zip
Southern C
onnecticut State University
Application for In-State Tuition
STEP T
HREE: PROOF OF DOMICILE
For students requesting reclassification under Category A, C, or E, this section is to be filled out by
the student; for students requesting reclassification under Category B this section is to be filled out
by the student’s parent or legal guardian; and for students requesting reclassification under
Category D this section is to be filled out by the student’s spouse.
Name (print) Phone ( ) ______________
Current
Residential Address _________________________________________________________
When did you establish permanent residency in Connecticut? __________________________
Month/Day/Year
Purpose of relocation to Connecticut?
Employment Education Other
If “other
” please explain: ___________________________________________________________
________________
________________________________________________________________
If you were out of C
onnecticut during the past 12 months, for more than 3 consecutive weeks,
give dates of your absence:
City,
State _______________________________________ To/From Dates: __________________
Reason: ________________________________________________________________________
City, State _______________________________________ To/From Dates: __________________
Reason: ________________________________________________________________________
City, State _______________________________________ To/From Dates: __________________
Reason: ________________________________________________________________________
Page 4 Revised 3/23/2020
Southern Connecticut State University
Application for In-State Tuition
STEP FOUR: AFFIDAVIT
I, __________________________________________________, hereby affirm that:
I currently reside in the state of Connecticut;
If I am filing under Category C, I have completed two years of high school level education in the
state of Connecticut and hold a Connecticut high school diploma or its equivalent;
I am registered as an entering student or am currently enrolled at SCSU; and
If I am undocumented or in Temporary Protected Status or Deferred Action for Childhood Arrivals, I
have filed an application to legalize my immigration status or will file an application to legalize my
immigration status as soon as I become eligible to do so.
To the best of my knowledge and belief, the information given in this application is complete and
accurate. I understand that students who falsify their information or intentionally submit inaccurate
information will be subject to the Student Code of Conduct.
_________________________________________________ ______________
Student Signature Date
STEP 5: SUBMIT APPLICATION
Please submi
t this completed application along with all supporting documentation from Page 5:
Prospective Students
Undergraduate
Undergraduate Admissions
501 Crescent Street
New Haven, CT 06515
Phone: (203) 392
-5644
Fax: (203) 392
-5727
admissions@southernct.edu
Prospective Students
Graduate
Graduate Admissions
501 Crescent Street
New Haven, CT 06515
Phone: (203) 392-9670
gradadmissions@southernct.edu
Undergraduate & Graduate
Registrar’s Office
501 Crescent Street
New Haven, CT 06515
Phone: (203) 392-5301
Fax: (203) 392-7144
registrar@southernct.edu
FOR OFFICE USE ONLY:
Approved, Effective Term: _____________________________ Denied
_________________________________________________ ______________
Signature: University Representative Date
Note: Students may create a digital ID using their SCSU email by clicking the signature block above, or the form
may be accepted as an attachment from their SCSU email without a signature.
click to sign
signature
click to edit
click to sign
signature
click to edit
Page 5
Revised 3/23/2020
Southern Connecticut State University
Application for In-State Tuition
Document Checkl
ist
All documents must be presented along with the application. The University reserves the right to request
additional documentation in review of your application.
All documents must be current and valid.
Application Category Proof of Identity Proof of Residency
Additional
Requirements
Applying as an
Emancipated Student
A
Student’s federal,
state, municipal, or
other valid and
unexpired government
issued photo ID
Two documents showing
student’s residency for
12 consecutive months
prior to start of current
term (i.e. mortgage,
lease agreement, utility
bill)
Front page of federal
and state tax returns
(please redact social
security number)
Student Financial Aid
Report
Applying as an
unemanicpated student
with parental/legal
guardian information
B
Student’s AND
Parent's federal, state,
municipal, or other valid
and unexpired
government issued
photo ID
Two documents showing
parent/legal guardian
residency for 6
consecutive months
prior to start of current
term (i.e. mortgage,
lease agreement, utility
bill)
Front page of
parent/legal guardian
federal and state tax
returns (please redact
social security number)
Applying as a CT High
School Graduate
C
Student’s federal,
state, municipal, or
other valid and
unexpired government
issued photo ID
Two documents showing
student’s residency (i.e.
mortgage, lease
agreement, utility bill)
All high school
transcript(s)
Applying with spousal
information
D
Student’s AND
Spouse's federal, state,
municipal, or other valid
and unexpired
government issued
photo ID
Two documents showing
spouse’s residency for 6
consecutive months
prior to start of current
term (i.e. mortgage,
lease agreement, utility
bill)
Marriage certificate
Front page of spouse’s
federal and state tax
returns (please redact
social security number)
Applying with military
orders
E
Student’s federal,
state, municipal, or
other valid and
unexpired government
issued photo ID
Military Orders
Front page of spouse/
parent federal and
state tax returns, if
applying under
spouse/parent military
orders.
(please redact social
security number)