ORR 11/2019
Office of the Registrar
601 W. Lombard Street, Suite 240
Baltimore, MD 21201
410-706-7480 | 410-706-4053 fax
Golden ID Eligibility Form
Senior citizens who meet all conditions listed below are eligible for admission to Golden ID status.
Senior citizen” includes any individual who:
Is 60 years old by the beginning of the semester for which they are registering
Is a resident of the State of Maryland
Is retired and not employed full-time*
The following programs are not available to students utilizing Golden ID benefits: the School of Medicine MD program; the MS
in Genetic Counseling; the School of Dentistry DDS program, Dental Post-Graduate Graduate programs, Dental Hygiene BS;
School of Nursing graduate (master's or doctoral) degree programs (i.e., RN to MS/MSN, MS/MSN, DNP, or PhD); MSHS
Physician Assistant program; MS in Forensic Medicine program; PhD Health Professions Education program; MS in Global
Health Systems & Innovation-Costa Rica Track; MS in Med Cannabis Sci Therapeutics program; and the School of Pharmacy
PharmD program. The preceding exclusions also apply if the student is pursuing a Post-Baccalaureate Certificate or not
pursuing a degree. UMB reserves the right to exclude other programs from Golden ID eligibility.
Semester Registering for: Fall Winter Spring Summer
Date of Birth: __________________
Last Name: _____________________________ First Name: __________________________________
Address: _______________________________________________________________________
City, State, Zip: __________________________________________________________________
Are you currently employed?
No Date of Retirement:
Yes Name of Employer:
Employer’s Address:
Number of hours per week:
If requested, I agree to provide UMB with evidence in support of this application. I understand that summary
dismissal is the penalty for giving false information. I understand that I must notify The Office of the Registrar at
UMB in writing immediately if my present status changes.
Applicant’s Signature: ______________________________________ Date: __________________________
Please return this form to The Office of the Registrar at UMB
*USM Board of Regents 254.0 VIII-2.30
Student meets requirements: Yes No
Notes and Comments:
Student applied to: _______________ (Program) and __________ (Term)
Forwarded to ______________ (School/Program) to review on __________
Student notified of decision: Yes No