2019–2020
Selective Service Verification
Student Financial Services • 1 Ferncroft Road • Danvers, MA 01923-0840
978-762-4189 www.northshore.edu/paying/financial-services
sfs@northshore.edu
Required (please print) CSELSV
Student ID#
N 0 0
Last Name: __________________________________________
First Name: __________________________________________
Read each of the three statements below.
Select the Category (A, B, C, or D) that best describes your situation and take the appropriate action immediately:
Category A
I am a male U.S. citizen or eligible non-citizen, born aer December 31, 1959, who is 18, but not yet 26 years of age.
You must register with Selective Service. To register online and for more information go to the Selective Service Web
site at http://www.sss.gov. Provide us with a copy of your registration card or a copy of the online verification
of your registration.
Category B
I am a male U.S. citizen or eligible non-citizen, born aer December 31, 1959, who has never registered with Selective Service.
Students that were non-citizens who first entered the US aer the age of 26 are not required to register.
If you are a male immigrant who first entered the United States past the registration age you may submit your ocial entry
documentation that shows the first date of entry. If the document submitted is acceptable, you will not need to complete the
following step. If the document submitted is not acceptable, you will need to follow the steps in Category C.
Category C
I am a male U.S. citizen or eligible non-citizen, born aer December 31, 1959, who is 18, but not yet 26 years of age.
If Category B does not apply or you cannot provide the documentation you must
complete page two of this form.
You will also need to complete a
“Request Status Information Letter,” which can be found on the Selective Service
Website at
www.sss.gov and mail it to Selective Service at the address provided. You will need to submit the Status
Information Letter you receive back from them. The letter can take up to three to four weeks to receive.
Category D
I certify that I am not required to be registered with Selective Service because:
I am a female.
I am in the Armed Services on active duty. Attach a copy of active duty military I.D.
I have not reached my 18th birthday.
I was born before 1960.
I am a resident of the Federated States of Micronesia or the Marshall Islands,
or permanent resident of the Trust Territory of the Pacific Islands (Palau).
Sign, date, and return this form to the Student Financial Services Oce.
We do not accept digital signatures.
_____________________________________________________________________________________________________________________________
STUDENT’S SIGNATURE DATE
Men who are from age 18 through 25 are required to register with
the Selective Service System. According to our records,
your Selective Service registration status was not confirmed.
In order to be eligible for financial aid, you must provide written
documentation as proof of your registration or exemption status.
2/1/19
(OVER)
