***An incomplete form will be returned to you and will delay processing***
Financial Aid Office
2019-2020 Citizenship Worksheet
Student Name_________________________________________________
Student ID#:_____________________
We have received the results of your Free Application for Federal Student Aid (FAFSA) and additional information
is needed to verify your citizenship status.
Please check the box which applies to you and provide one of the types of documentation listed.
I am a U.S. citizen
Acceptable citizenship documents: birth certificate, Certificate of Citizenship (N-560 or N-561), Certificate of Naturalization
(N-550 or N570), U.S. passport, Consular Report of Birth Abroad (Form FS-240), Certificate of birth issued by a foreign service
post (FS-545), or Certification of Report of Birth (DS-1350).
I am an eligible noncitizen
Common citizenship/immigration documents which are acceptable:
o Permanent Resident – Permanent Resident Card or Resident Alien Card
o Conditional Resident Alien – Forms I-551, I-94, I-94A
o Arrival Departure Record (I-94) from the Department of Homeland Security showing the following:
o Refugee
o Asylum Granted
o Parolee
o Cuban/Haitian Entrant
o Conditional Entrant
o Victim of Human Trafficking
o Battered immigrants-qualified aliens
Other documents may be acceptable in certain circumstances. If you do not have any of the documents listed above, feel free to
contact our office for assistance or submit documents you have so that we may review them to determine whether or not they
meet requirements.
Name of Citizenship/ Immigration Documents Submitted
Expiration Date (if any) of Citizenship/
Immigration Documents
I certify that the citizenship/immigration documents submitted with this statement are the true, exact, and
complete copies of the originals issued to me. I understand that if I purposely give false or misleading information
you may be fined, be sentenced to jail, or both.
Student Signature
Please return this completed worksheet to:
Caldwell Campus
2855 Hickory Blvd.
Hudson, NC 28638
Fax: 828.726.2709
Email: finaid@cccti.edu
Watauga Campus
P.O. Box 3318
Boone, NC 28607
Fax: 828.297.1729
Email: finaid@cccti.edu
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