Virginia Military Institute Lexington, Virginia 24450-0304 Click here to view VMI’s Non-Discrimination Statement.
Application for Virginia in-state tuition rates
is form should be completed if you are claiming entitlement to Virginia in-state tuition rates pursuant to section 23-7.4, Code of Virginia. All
questions must be answered.
Section A must be completed by the applicant. Section B must be completed by the parent or legal guardian if the applicant
is under the age of 19 and is not married or if the applicant is a dependent. Supporting documents and additional information may be requested.
SECTION A — APPLICANT
1. Name of applicant ______________________________________________________________________________________________
2. Date of birth ______________________ 3. Citizenship: _____ U.S. _____ Non-U.S. If non-U.S., give visa type__________________
month/day/year
4. Where have you lived for the past two years? List current address first:
FROM TO
(mo/yr) (mo/yr) ADDRESS CITY STATE ZIP
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
5. Do you currently reside in Virginia? If yes, for how long? ___________________________ ___ Yes ___ No
6. Do your parents or legal guardian provide over half of your financial support or claim you as a tax dependent? ___ Yes ___ No
If yes, Section B must also be completed by parent or legal guardian.
7. Will you have filed a tax return or paid income taxes to any state other than Virginia during the past year? ___ Yes ___ No
If yes, which state? _________________________________________________________
8. For at least one year prior to the term in which you will enroll, will you have
A. filed a tax return or paid income taxes to Virginia on all earned income? ___ Yes ___ No
B. been a registered voter in Virginia? ___ Yes ___ No If yes, give date______________________________
C. held a valid Virginia drivers license? ___ Yes ___ No If yes, date issued___________________________
9. Do you own or operate a motor vehicle? ___ Yes ___ No
If yes, has it been registered in any state other than Virginia during the past year? ___ Yes ___ No
10. Are you the “military dependent” of an individual currently on active duty assigned to a permanent duty station in Virginia?
___ Yes ___ No
If yes, check: _____ mother _____ father _____ legal guardian If yes, please provide the following items:
A. A copy of military orders verifying active duty military status and permanent duty station within Virginia
B. Documentation verifying Virginia residence
C. Copy of your military dependent card issued by the military
11. Answer this question only if you live outside Virginia, but work in Virginia:
Will you have lived outside Virginia, worked in Virginia, earned at least $14,500, and paid Virginia income taxes on
all taxable income earned in this Commonwealth for at least one year prior to the term in which you will enroll? ___ Yes ___ No
I certify, under penalty of disciplinary action, the information I have provided is true.
Date _______________________________ Signature of applicant ___________________________________________________________
This form should be submitted via mail or uploaded to our secure site: vmi.edu/admissions/upload
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Virginia Military Institute Lexington, Virginia 24450-0304 Click here to view VMI’s Non-Discrimination Statement.
SECTION B — PARENT OR LEGAL GUARDIAN
1. Name of applicant _______________________________________________________________________________________________
2. Name of parent or legal guardian ____________________________________________________________________________________
3. Relationship to applicant____________________________________________________________________________________________
4. Citizenship: _____ U.S. _____ Non-U.S. If non-U.S., give visa type________________________________________________________
5. How long have you lived in Virginia? _________________________________________________________________________________
6. Where have you lived for the past two years? List current address first:
FROM TO
(mo/yr) (mo/yr) ADDRESS CITY STATE ZIP
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
7. Will you have filed a tax return or paid income taxes to any state other than Virginia during the past year? ___ Yes ___ No
If yes, which state? _________________________________________________________
8. Will you have claimed the applicant as a dependent on your federal and Virginia income tax returns
for the tax year prior to the term in which the applicant will enroll? ___ Yes ___ No
9. Will you have provided over half of the applicants financial support for at least one year prior
to the term in which the applicant will enroll? ___ Yes ___ No
10. For at least one year prior to the term in which the applicant will enroll, will you have
A. filed a tax return or paid income taxes to Virginia on all earned income? ___ Yes ___ No
B. been a registered voter in Virginia? ___ Yes ___ No If yes, give date______________________________
C. held a valid Virginia drivers license? ___ Yes ___ No If yes, date issued___________________________
11. Do you own or operate a motor vehicle? ___ Yes ___ No
If yes, has it been registered in any state other than Virginia during the past year? ___ Yes ___ No
12. Are you or your spouse currently on active duty assigned to a permanent duty station in Virginia? ___ Yes ___ No
If yes, check: _____ self _____ spouse
If yes, is the applicant a “military dependent” of the family member currently on active duty assigned to a permanent duty station in Virginia?
___ Yes ___ No If yes, please provide the following items:
A. A copy of military orders verifying active duty military status and permanent duty station within Virginia
B. Documentation verifying Virginia residence
C. Copy of your military dependent card issued by the military
13. Were you a resident of the Commonwealth of Virginia and a member of the Foreign Service Oce who received a foreign service assignment?
___ Yes ___ No If yes, date of foreign service assignment: _________________________________
14. Answer this question only if you or your spouse live outside Virginia, but work in Virginia:
A. Will you or your spouse have lived outside Virginia, been employed in Virginia, earned at least $14,500,
and paid Virginia income taxes on all taxable income earned in this Commonwealth for at least one year
prior to the term in which the applicant will enroll? ___ Yes ___ No
B. If the answer to A is “Yes,” will the parent employed in Virginia have claimed the applicant as a dependent for
federal and Virginia income tax purposes for at least one year prior to the term in which the applicant will enroll? ___ Yes ___ No
I certify all the information provided is true.
Signature of parent or guardian____________________________________________________ Date _______________________________
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