Fillable Non Resident Tuition Exception Request Form 1112019

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Non Resident Tuition Exception Request Form 1112019

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The Non Resident Tuition Exception Request Form 1112019 form is 1 page long and contains:

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  • 8 check-boxes
  • 16 other fields

Country of origin: US
File type: PDF

U.S.A. forms for University of Southern Mississippi

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Please Mail to: 118 College Drive #5171, Hattiesburg, MS 39406 or 601.264.4629
730 East Beach Blvd, Long Beach, MS 39560 or 228.214.3244
or email va@usm.edu
AA/EOE/ADAI
Center for Military Veterans, Service Members and Families
Non-Resident Tuition Exception Request Form
Name of Student/Applicant: ID:
Date of Birth: Admit Term: Fall 20 Spring 20 __ Summer20 _ ______
Address:
City: State: Zip:
Relationship to Veteran/Service Member (check one):
Self Spouse Son Daughter Step-Son
Step-Daughter Adopted Son Adopted Daughter
Name of Veteran/Service-Member:
Branch of Service: Dates of Service:
Type of Discharge (If Applicable):
Proof of Service and/or Status:
*Veteran/Service Member
**Dependents
Copy of Valid Military ID Card
Copy of Valid Dependent Military ID Card
Copy of DD-214 (member 4 copy)
Copy of Expired Dependent Military ID Card
Copy of Active Duty Orders
Copy of Dependent Birth Certificate or
DEERS Printout
Other Documentation (As Required)
Other Documentation (As Required)
*Veterans/Service Member must provide one of the above listed items as proof of service and/or
status
.
*
*Dependents must provide one item from the Veteran/Service Member list and one item from
the Dependents list.
Attach the documentation to this request no later than the last day to add full-term
classes without permission.
Print and sign the form and return it as directed below.
Student: Date
Veteran/Service Member: Date
Office Use Only:
Active Duty Veteran
Approved Date
Not Approved Date
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Non Resident Tuition Exception Request Form 1112019

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Completed 5 March 2020

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