UMGC Office of Financial Aid | 3501 University Boulevard East, Adelphi MD 20783 USA
Federal law requires men age 18 through 25 to register with the Selecve Service System. According to your
Free Applicaon for Federal Student Aid (FAFSA), the Department of Educaon was unable to verify your
Selecve Service registraon or exempon. You must resolve any conicts regarding your
Selecve Service status before being awarded Federal Student Aid.
Instrucons: Please complete all secons that pertain to your situaon. All students must complete Part D on page 2.
Part A – Selecve Service Registraon Conrmaon
I cerfy that I am registered. Please submit supporng documentaon including a copy of your registraon
acknowledgement card, your web cercaon, or Status Informaon Leer from the Selecve Service. To register
or request a Status Informaon Leer, go to www.sss.gov.
Part B – Selecve Service Exempon
If you are exempt from registering with Selecve Service, please select an excepon from below. Please follow all
instrucons associated with the exempon you select including subming addional 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: Official government-issued document
showing date of birth such as state ID card, driver’s license, passport, or birth certificate.
I am on active duty in the U.S. armed forces. (Does not apply to Reserve or Guard members unless currently
on Active Duty status.) Documentation Required: A copy of your Leave and Earning Statement (LES) for the
most recent month.
I was in the military. Documentaon Required: Please aach 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 Pacic Islands (Palau). Documentaon 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 I turned 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
26th birth-day, you must provide proof that you were not living in the U.S. 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-cizen who entered the US as lawful nonimmigrant on a valid visa and remained in the U.S. on
the terms of that visa unl aer I turned 26. Documentaon Required: For example, if you entered the United
States on an F-1 student visa and remained in that status unl your 26th birthday, you would need to provide
documentaon indicang that you were admied on an F-1 visa and aended school full-me as required. Ac-
ceptable documentaon for this situaon includes a copy of your I-20 form or a leer from the school(s) you
aended indicang your full-me aendance as a non-immigrant alien. The same requirement applies for all
non-immigrant statuses. Please note: If, at any me, your cizenship status changed before the age of 26, you
may have been required to register with Selecve Service. For example, if you were a male who became an
eligible non-cizen on your 23
rd
birthday and you were no longer on an F-1 student visa, you were required to
register at that me. If this scenario is representave of your situaon, please address your circumstance for
not registering in Part C.
FSELSR
Page 1 of 2
Form: Selective Service Verification
Student’s ID #: _ Student’s Name: _________________________________________
Please scan and submit this completed form at www.umgc.edu/help/submit-case.cfm.
