Fillable Request for In-state Classification for Tuition Assessment (Wayne State University)

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Request for In-state Classification for Tuition Assessment (Wayne State University)

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Request for In-state Classification for Tuition Assessment
ESP@wayne.edu
Mail/Fax/Email to: Records and Registration Office Drop Off: Student
Service Center Lobby
Welcome Center
42 W. Warren
Detroit, MI 48202
Phone: (313) 577-2100
August 2017 Page 1 of 4
After registering, students may petition for a change of classification for
tuition assessment through the Office of the
Registrar using this form. Documentation must accompany all petitions.
Do not use this form if you have never registered for classes. Contact the admissions office for reconsideration:
Office of Undergraduate Admissions: http://admissions.wayne.edu/contact.php
Office of Graduate Admissions: http://gradschool.wayne.edu/future/contact.php
Do not apply if any of the following circumstances apply to you -- in-state tuition cannot be approved:
• You came to Michigan for educational purposes. Did you register as a full time student within six months of your
arrival in the state? Have you continued as a full time student since your arrival in Michigan? If yes to these
questions, do not apply.
• You have an F1 Student Visa.
• You are in a medical residency, fellowship, or internship.
• Your employment is a temporary or short-term job or a position normally held by a student.
Documentation must accompany your application for each area pertinent to your request. Examples of
documentation are listed for each of the question areas. Additional information may be requested as your application is
reviewed.
Please answer all questions completely, using “none” or “N/A” for those which do not apply to your situation. If responses
do not fit in the space provided please use additional paper.
ALL COMMUNICATIONS AND DECISIONS ARE THROUGH YOUR WSU E-MAIL ADDRESS
.
The Board of Governors Code Annotated regarding Tuition Regulations and Review Procedures is at
http://bog.wayne.edu/code/2_34_03.php
Apply for in-state classification consideration if:
• You lived in Michigan more than six months prior to your first term of full time registration.
• You took a break in your education for six or more months while remaining in Michigan.
• You came to Michigan for reasons other than education (job relocation, parent relocation, spouse or domestic
partner relocation).
• You are a veteran or a member of a military family.
• You had a temporary absence from Michigan.
• Your Visa type changed from an F1 Student Visa to U.S. Citizenship; permanent resident; work permit; asylum; or
visa types A, E, G, H, I, L, R, or TN.
o
Please update your status with the Office of International Students & Scholars (OISS) before submitting
the in-state tuition a
pplication.
Except for documented delays caused by University personnel, Applications for Residence Classification are due:
Fall Term and the Medical Year Term - September 30
Winter Term - January 31
Spring/Summer Term - July 31
Deadlines falling on weekends are extended to the next business day.
Applications received after these dates are processed for the following term.
5057 Woodward, Fourth Floor
Detroit, MI 48202
Phone: (313) 577-3541, #5
Fax: (313) 577-0945
Request for In-state Classification for Tuition Assessment
ESP@wayne.edu
Mail/Fax/Email to: Records and Registration Office Drop Off: Student Service Center Lobby
Welcome C
enter
42 W. Warren
Detroit, MI 48202
Phone: (313) 577-2100
Page 2 of 4
1. Name ______________________________________________________________ WSU Access ID: ______________________
Which term/year are you requesting in-state tuition? ________________________________
2. Please explain why you should be classified a Michigan resident for tuition assessment.
3.
Present mailing address ___________________________________________________________________________________
number and street
city
state
zip code
4. Permanent address ________________________________________________________________________________________
number and street
city
state
zip code
5.
Living arrangements:
House:
o
wn
rent
; In rented room or apar
tment:
; with parent(s)/guardian(s):
with spouse or partner:
; with other relatives (specify):
__________________________________________________;
________________________________________________________________________________.
6.
Place of birth __________________________ If not in the US, what is your citizenship? __________________________________
If not a US citizen, type of Visa ______________ Issued where and date ____________________________________________
Documentation: If not a US citizen provide a copy of your current visa and passport. If you are an
Asylee provide copies of
your paperwork. If you are an undocumented immigrant, please send an email directly to ESP@wayne.edu for advice on
what to provide with this application.
If you have an F1 Student Visa STOP; you cannot be approved for in-state tuition. If you have had a change from an F1
Student Visa please visit OISS to update your status before submitting this application.
7.
Documentation: If you spouse/partner is the basis for this request, documentation regar
ding their residency in
Michigan willbe needed. A copy of your marriage or domestic partnership certificate will be required. If your
request is due to a spouse/partner’s recent job change, provide a copy of their offer letter or a pay stub with
their Michigan address
August 2017
term
year
/
Visa issuing jurisdiction
Issue date
Do you have a spouse or domestic partner? Yes No If yes, date of marriage or partnership _____________________
Spouse/Partner’s name _________________________________________ If not US citizen, Visa Type _____________________
Spouse/Partner’s legal residence ________________________________________ Since what date _______________________
Spouse/Partner's employment Since what date _______________________
with friends (specify):
;
5057 Woodward, Fourth Floor
Detroit, MI 48202
Phone: (313) 577-3541, #5
Fax: (313) 577-0945
Reset Form
Request for In-state Classification for Tuition Assessment
ESP@wayne.edu
Mail/Fax/Email to: Records and Registration Office Drop Off: Student Service Center Lobby
Welcome Center
42 W. Warren
Detroit, MI 48202
Phone: (313) 577-2100
August 2017
Page 3 of 4
8. If you receive any financial support from your parents or guardians, or are under 18, answer the following:
Parent/Guardian Name ________________________________ Address _______________________________________________
City State Country
Parent/Guardian Name ________________________________ Address _______________________________________________
City State Country
If addresses differ, explain: ____________________________________________________________________________________
Documentation
: If your parents/guardians moving to Michigan is the basis for this request, documentation regarding their
residency in Michigan and a copy of your birth certificate will be needed.
If your request is due to a parent/guardian’s recent job change, provide a copy of their offer letter or a pay stub with their
Michigan address.
Tax Returns: A previous year’s Michigan State or Federal tax filing showing you as a dependent.
9. List your source of financial support; if several, itemize amounts and percentages _______________________________________
________________________________________________________________________________________________________
10. When did you come (or last return) to Michigan to live? (date) ____________ From (place) ______________________________
For what purpose? _________________________________________________________________________________________
Have you resided in Michigan previously? ___________ Explain ____________________________________________________
________________________________________________________________________________________________________
List where you have resided for the past five years:
City, State, Country From date To date
Documentation: Provide a copy of the first pages of a lease or purchase agreement showing dates residency began in
Michigan. This is not necessarily your current lease but rather one that may show you residing in the state six or more months
prior to the beginning of the semester.
If you are in an informal living arrangement, provide a sworn, notarized statement from your roommate or landlord. This
should include the address, date the arrangement began, any payment arrangements, and the landlord/roommate’s name
clearly written with contact information.
Name: ___________________________________________ WSU Access ID: _______________
5057 Woodward,
Fourth Floor
Detroit,
MI 48202
Phone: (313) 577-3541, #5
Fax: (313) 577-0945
Request for In-state Classification for Tuition Assessment
ESP@wayne.edu
Mail/Fax/Email to: Records and Registration Office Drop Off: Student Service Center Lobby
Welcome Center
42 W. Warren
Detroit, MI 48202
Phone: (313) 577-2100
Page 4 of 4
11. List your places of employment for the past five years:
Employer City, State, Country Dates of Employment Hours/Week
Documentation: If you have been employed in Michigan, provide a copy of the oldest paystub you have access to showing
your Michigan address(es).
12. List chronologically all high schools, colleges or universities you have attended including WSU
Name of School City, State, Country Terms/Years
Documentation
: If you are claiming temporary absence from Michigan due to education in another state, provide
documentation of your previous education at a Michigan institution. This could be a copy of a high school diploma or
transcript.
Additional Documentation:
• Copy of Michigan driver’s license if valid
• Tax Returns: A previous year’s Michigan State and/or Federal tax filing
Certification and Signature: I hereby certify that the information given is true, correct, and complete to the best of my knowledge, and
that I am not claiming residence in another state or country for any purpose.
Signed ____________________________________________________________ Date _________________________
Phone number _________________________________________
For Office Use:
Decision by Office of the Registrar: Non-Resident
Resident effective term ___________________
By _______________________________________________ Date ___________________________
Program _______________________________ Unit ______________________________ Class ________________
August 2017
Name: ___________________________________________ WSU Access ID: _______________
5057 Woodward, Fourth Floor
Detroit, MI 48202
Phone: (313) 577-3541, #5
Fax: (313) 577-0945
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Request for In-state Classification for Tuition Assessment (Wayne State University)

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Completed 24 July 2020

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