Fillable RESIDENCY INFORMATION FORM (East Tennessee State University)

Fill Online, Printable, Fillable, Blank RESIDENCY INFORMATION FORM (East Tennessee State University) Form

Use Fill to complete blank online EAST TENNESSEE STATE UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

RESIDENCY INFORMATION FORM (East Tennessee State University)

On average this form takes 13 minutes to complete

The RESIDENCY INFORMATION FORM (East Tennessee State University) form is 2 pages long and contains:

  • 1 signature
  • 9 check-boxes
  • 42 other fields

Country of origin: US
File type: PDF

U.S.A. forms for East Tennessee State University

BROWSE EAST TENNESSEE STATE UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
❏
❏
❏
❏
❏
❏
❏
❏
❏
❏
❏
❏
Reset Entire Form
RESIDENCY INFORMATION FORM
E ast Tennessee State University - School of Graduate Studies - P.O. Box 70720 - Johnson City, Tennessee -
37614 -1710
Complete this form
for evaluation of residency status.
Return to:
Office
of Graduate Studies Box 70720
Johnson City
, TN 37614-1710
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK.
CURRENT DATE
A. STUDENT INFORMATION
E#
(if available)
Full Legal Name
LAST FIRST MIDDLE MAIDEN SURNAME
Are you currently enrolled at ETSU? Yes No If no, are you currently enrolled as a full-time student (as defined by your insti-
tution) at any college or university? Yes No
College Name
City and State
Sex Male Female Marital Status Married Single
If presently married, date of marriage
MONTH DAY YEAR
Date of Birth Place of Birth
MONTH DAY YEAR CITY COUNTY STATE
U.S. Citizen Yes No If no, type of visa
Legal permanent address at time of this application
STREET CITY STATE ZIP CODE
COUNTY (AREA CODE) TELEPHONE NUMBER
Length of time at this address Years Months
Do you own or rent this dwelling?
own rent Other (explain on a separate sheet, if necessary)
How long have you lived in Tennessee (or a border county*)? Years Months
Why did you move to Tennessee (or a border county)?
Voter Registration State
Driver's License Number State Date Issued
*Residents of border counties (Ashe, Avery, Haywood, Madison, Mitchell, Yancy, or Watauga counties in North Carolina, or Grayson,
Lee, Scott and Washington counties, or Bristol city in Virginia) are eligible for in-state tuition if they complete the request for in-state
tuition rate form (page 39) in addition to this form by the 14th day of the semester.
1
❏ ❏
❏
❏ ❏
❏
B. PARENTAL INFORMATION
Name and Address
LAST
FIRST MIDDLE
STREET CITY STATE ZIP CODE
C.
(AREA CODE) TELEPHONE NUMBER
Length of time at this address Years Months
Have your parents surrendered the right to care, custody, and earnings of you? Yes
Were you claimed as a dependent on the most recent income tax return by your parents?
EMPLOYMENT
Please list your most recent places of employment.
1.
NAME OF EMPLOYER STREET
DATE OF EMPLOYMENT FULL- OR PART-TIME
2.
NAME OF EMPLOYER STREET
No
CITY
Yes No
Currently Employed
CITY
Yes
STATE
No
STATE
3.
DATE OF EMPLOYMENT
NAME OF EMPLOYER
FULL- OR PART-TIME
STREET CITY STATE
DATE OF EMPLOYMENT FULL- OR PART-TIME
If married, spouse’s occupation and place of employment:
NAME OF EMPLOYER STREET CITY STATE
DATE OF EMPLOYMENT FULL- OR PART-TIME
D. Please use this space for additional comments.
E. I certify that the information presented in this form is correct to the best of my knowledge and belief.
SIGNATURE OFAPPLICANT DATE
This form must be processed by the last day of registration (official census date) of the semester in order to be effective with that semes-
ter.
2
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

RESIDENCY INFORMATION FORM (East Tennessee State University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 20 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document