OUT-OF-STATE NJIT TUITION EXEMPTION
For Eligible New Jersey High School Graduates
APPLICATION AND AFFIDAVIT
Complete and sign this form to request exemption from Out-of-State tuition charged to non-New Jersey residents. Mail or deliver in-
person the form and your official NJ high school transcript(s) to:
New NJIT students: Office of University Admissions, Fenster Hall, Room 100, University Heights
Newark, NJ 07102
Continuing students: Office of the Registrar, Student Mall, University Heights
Newark, NJ 07102
If you are determined to be eligible, you will continue to receive exemption from out-of-state tuition status as long as you fulfill the
requirements or the University no longer offers this exemption, whichever occurs first. Applying for the exemption does not in any way
alter your responsibility to pay on time any tuition and fees that may be due before eligibility is determined. You must complete all
sections of this form.
APPLICATION
I, the undersigned, am applying for Out-of-State tuition exemption and declare that all of the following apply to me:
1. I have attended high school in New Jersey for three or more years; and
2. I have graduated from a New Jersey high school or have attained the equivalent thereof, such as a High School
Equivalency diploma, issued by the State of New Jersey Department of Education; and
3. I am NOT a non-immigrant alien with a currently valid visa
Please provide information on all schools you attended in grades 9-12:
High School City State From Month/Year To Month/Year
NOTE: You must submit this Affidavit with your official high school transcript(s) including all courses and grades to date. If you have
already graduated from high school, you must submit your final official high school transcript.
AFFIDAVIT
By signing this document, I hereby state that if I am a non-citizen without lawful immigration status, I have filed an application to
legalize my immigration status or will file an application as soon as I am eligible to do so.
DECLARATION OF TRUE AND ACCURATE INFORMATION
I, the undersigned, declare that the information I have provided on this form is true and accurate. I understand that this information
will be used to determine my eligibility Out-of-State tuition exemption. I further understand that if any of the above information is
found to be false, I will be liable for payment of all out-of-state tuition charges from which I was exempted and may be subject to
disciplinary action by the University.
____________________________________________ __________________________________________________
Full Name
(as it appears on your application or student record) NJIT Identification Number
____________________________________________ _____________________________ __________________
Permanent Address E-mail Address Phone Number
____________________________________________ ____________________________
Signature Date
2014-JAN-17
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