EASTERN ILLINOIS UNIVERSITY
RESIDENCY CLASSIFICATION APPEAL FORM
University policy requires documented establishment of residency four months prior to the term for which you are
requesting Illinois tuition and fee rates. The information we have suggests you may not be a bona fide resident for tuition
and fee purposes. Therefore, you have been classified as a "nonresident" at this time.
If you wish to appeal this classification you must complete this form and return it along with documentation that allows
us to determine if and when you established Illinois residency. This documentation is normally a copy of a voter's
registration application form, driver's license, or marriage license (plus spouse's driver's license), etc. Additional
information regarding residency may be found in the University Catalog.
NAME _______________________________________________ E# ______________________
(Last/First/Mid/Maiden)
TERM FOR WHICH YOU ARE REQUESTING RESIDENT STATUS ___________________
HOW LONG HAVE YOU CONTINUOUSLY RESIDED IN ILLINOIS? Years ____ Months ____
If less than one year, give the date when you moved into the state _______________________
MAILING ADDRESS PERMANENT ADDRESS
Street _______________________________ _______________________________
City _______________________________ _______________________________
State/Zip _______________________________ _______________________________
PHONE _____________________________ E-MAIL __________________________________
BIRTHDATE ______/______/______ AGE ________ BIRTHPLACE _____________________
ARE YOU CLAIMED BY ANYONE AS A DEPENDENT FOR TAX PURPOSES? __ Yes __ No
If yes, what is your relationship to this person? _____________ What is their name and address?
___________________________________________________________________________
Name/Address/City/State/Zip
EVIDENCE BEING SUBMITTED FOR CONSIDERATION (Please circle)
Voter's Registration Application - IL Driver's License - Military Papers - IL Tax Return
Marriage License - Other (Please list) ____________________________________________
Use the other side of this page for additional information you think is important.
___________________________ ________________________________________________
Date Signature
Return Signed Form and Supporting Documents to:
Office of The Registrar
Old Main, Room 1220
600 Lincoln
Charleston, Illinois 61920-3099
