YubaCommunityCollegeDistrict
FinancialAidOffices
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
LakeCounty Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
20202021SelectiveServiceForm
____________________________________________________________ __________________________________
LastName FirstName M.I. StudentIDNumber
____________________________________________________________ __________________________________
MailingAddress(includeapt.no.)DateofBirth
____________________________________________________________ __________________________________
City State ZipCode PhoneNumber(includeareacode)
AccordingtoFederalLaw,mostmalesmustregisterwithSele ctiveServicetoreceivefederalstudentaid.Ifyou
areafemaleorwerebornbefore1960,registrationisnotrequired.Ifyouareamalebetweentheagesof18
through25,youmustregisterwithSelectiveServicetobe
eligibleforfinancialaid.
If you believe you have already registered with Selective Service, please provide confirmation of your
registration(e.g.acopyofyourSelectiveServiceRegistrationAcknowledgment).
Ifyoudidnotregister,youcanregisterwithSelectiveServicebydoingoneofthefollowing:
Registeronthe
Webatwww.sss.gov.
CompleteaSelectiveServiceRegistrationformatyourlocalpostoffice.
Answer"Yes"toItem22onyourStudentAidReport(SAR)andreturnyoursignedSARto
theDepartmentofEducation.
IfyoudidnotregisterwithSelectiveService,andareamalenow
26orolder,youareineligibleforFederal
student aid. You may submit an appeal to the Financial Aid Office explaining the reasons for your failure to
register.Youmustdothefollowing:
1. Obtaina"StatusInformationLetter"fromSelectiveService.Youcandownloadthe"RequestforStatus
Information
Letter"ontheWebatwww.sss.gov.
2. AssoonasyoureceivetheStatusInformationLetterfromSelectiveService:
SubmitacopyoftheStatusInformationLettertotheFinancialAidOffice
IncludeatypedstatementexplainingwhyyoudidnotregisterwithSelectiveService
Attachanysupportingdocumentationwithyourappealrequest
I certify that the information provided is true and correct to the best of my knowledge. I understand that this
informationwillbeused to determine my eligibility for financial aid andthatfalseormisleadinginformationmay be
causefordenial,termination,and/orrepaymentoffinancialaidfunds.
________________________________________________________ _______________________________
StudentSignatureDate
Page1SelectiveService
Rev.9/30/19
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signature
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FORFINANCIALAIDOFFICEUSEONLY
DocumentationSubmitted: StatusInformationLetter PersonalStatement
SupportingDocumentation_________________________________________________________________________
Decision: Approved Denied
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FinancialAidSignature Date
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