Fillable Citizenship Form A. Student Information (Eastern Florida State College)

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Citizenship Form A. Student Information (Eastern Florida State College)

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The Citizenship Form A. Student Information (Eastern Florida State College) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for Eastern Florida State College

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* 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.
02/05/19
CITIZN
FA Eligibility
Citizenship Form
The Social Security Administration has not confirmed your registration or exemption status. You must provide Eastern
Florida State College verification of your U.S. citizenship status to determine eligibility for federal student aid.
Priority Deadlines*: Summer 2019 – 04/18/19 | Fall 2019 – 07/18/19 | Spring 2020 – 11/25/19 | Summer 2020 – 04/23/20
A. Student Information
B#
Last Name First Name M.I. Student ID
B. Citizenship Status
Please select the appropriate status and provide any documentation listed.
☐ I am an eligible U.S. citizen. Attach ONE of the following documents:
☐ U.S. Birth Certificate; includes Puerto Rico (on or after January 13, 1941), Guam, the U.S. Virgin Islands (on
or after January 17, 1917), American Samoa, Swains Island, or the Northern Mariana Islands.
☐ U.S. Passport; current or expired, except “limited” passports
☐ Wallet sized passport card; current or expired, except “limited” passports
☐ Certificate of Naturalization
☐ Certificate of Citizenship
☐ Certificate of Birth Abroad; Form FS-240, FS-545, or DS-1350
☐ I
am an eligible Non-Citizen. Attach ONE of the following documents:
☐ Unexpired Permanent resident card I-1551
☐ Unexpired Resident alien card I-551
☐ Unexpired Alien Registration card I-151
☐ I-94 Arrival-Departure Record; Form CBP I-194A or CBP I-94
☐ Unexpired United States travel document (Contains Form I- 327 & Form I-571)
☐ Unexpired Machine Readable Immigrant Visa (MRIV)
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
2
C. Certification and Signature
By signing below I certify that all of the information reported is
complete and correct.
Student’s Original Signature (cannot be signed electronically) Date
D. Document Submission
You may submit this document by the following methods:
1. EFSC DOCUMENT DROPBOX (RECOMMENDED)
Print and complete this document (including the original signature), scan the document, and upload the
document via the Document Dropbox in myEFSC. Printers and scanners are available in EFSC’s open
computer labs and libraries.
2. IN PERSON
Submit your document in person at the Office of Financial Aid on any campus:
Cocoa
Building 11, Room 209
Monday through Thursday, 8 a.m. to 7 p.m.
Palm Bay
Building 1, Room 117
Monday through Thursday, 8 a.m. to 7 p.m.
Melbourne
Building 1, Room 137
Monday through Thursday, 8 a.m. to 7 p.m.
Titusville
Building 3, Room 125
Monday through Wednesday, 8 a.m. to 5:30 p.m.
Thursday, 8 a.m. to 7 p.m.
3. BY MAIL
Mail your document to the Office of Financial Aid on any campus:
Cocoa
Eastern Florida State College
Office of Financial Aid, C11-209
1519 Clearlake Road
Cocoa, FL 32922
Palm Bay
Eastern Florida State College
Office of Financial Aid, PB1-117
250 Community College Parkway
Palm Bay, FL 32909
Melbourne
Eastern Florida State College
Office of Financial Aid, M1-137
3865 N. Wickham Road
Melbourne, FL 32935
Titusville
Eastern Florida State College
Office of Financial Aid, T3-125
1311 N. US 1
Titusville, FL 32976
QUESTIONS?
Financial Aid Specialists are available at the campus locations listed above, by phone at 321-433-7339, and via e-mail at
finaid@easternflorida.edu.
Eastern Florida State College is committed to equal access/equal opportunity in its programs, activities, and employment.
For additional information, visit Eastern Florida State College: easternflorida.edu/go/equity.
WARNING: If you purposely give false
or misleading information, you may be
fined, sent to prison, or both.
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Citizenship Form A. Student Information (Eastern Florida State College)

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Completed 21 July 2020

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