OFFICE OF ADMISSIONS
AFFIDAVIT OF INTENT
Process for Accessing In-State Tuition for Undocumented/DACA students
AFFIDAVIT INSTRUCTIONS:
1. This Afdavit must be fully and properly completed (please use ink and must be in English).
2. This Afdavit must be signed and dated before the student plans to enroll at EIU.
GENERAL INFORMATION
Applicant’s Name
Last Name:
Given or First Name:
Address
Street Address:
City: State: ZIP Code:
Declaration of Intent and Certication
I,
, a citizen of
(Student) (Country)
am not a permanent resident of the United States. I agree to le an application to become a permanent resident of the United States at
the earliest opportunity. I am required to do so in order to be eligible for tuition rates.*
I resided with my parent(s) or guardian(s) while attending high school. My address(es) during my high school attendance was (were):
• I graduated from a high school in the United States or received the equivalent of a high school diploma.
• I attended this high school for at least 3 years.
• I authorize Eastern Illinois University to verify my statements in this afdavit. I consent to the disclosure of information by any high
school I have attended concerning my residence and that of my parent(s) or guardian(s).
I certify that all information provided on this afdavit and on the attached documents (if any) proving my intent to become a permanent
United States resident is true and valid. I further certify that I understand this afdavit is a binding document.
Student Signature:
Date:
*Applicants residing in states other than Illinois, Indiana, Iowa, Kentucky, Michigan, Missouri and Wisconsin must
have a minimum 3.0 gpa on a 4.0 scale to qualify.
Return to:
Eastern Illinois University Ofce of Admissions; 600 Lincoln Ave., Charleston, IL 61920-3099 or email to admissions@eiu.edu
