Exemption of Nonresident Surcharge
Your answer to ONE of the following criteria must be yes to qualify under option C, and all documentation will be required when
this form is submitted. If you enroll in 4 credits or less per semester, fees will be assessed at the resident rate. Once you enroll
in 5 or more credits, the non-resident surcharge is applied to ALL registered credits.
I am eligible for resident tuition assessment because I am:
United States military personnel on active duty, their spouse, or dependent child. (Ofce use only: Military ID veried by:
A member of the National Guard and Reservists, their spouse, or dependent child.
The dependent child of a person who graduated and holds an associate, bachelor, master or doctoral degree from the
University of Alaska.
Parent name at time of graduation:
Date of birth:
Year parent or guardian graduated from University of Alaska:
The dependent child of an Alaska resident.
A student participating in the Western Interstate Commission on Higher Education (WICHE) Western Regional Graduate Program (WRGP).
A student from another state or province whose public universities waive nonresident tuition surcharges for Alaska residents as listed in
UA Regulation 05.10.050.
A student from a foreign city or province that has established sister city or sister province relationships with the State of Alaska, or Alaska
municipalities, and that has been appr
ved by the president as listed in UA Regulation 05.10.050.
ThespouseordependentchildofaUniversityofAlaskaemployeeinabenet-eligibleposition.(Ofce use only: veried by:
Employee name: Employee ID:
State of Alaska, issue a diploma recognized by the Alaska Department of Education, and:
• be a public high school listed in the current State of Alaska Department of Education directory; or
• be accredited by the Northwest Association of Accredited Schools; or
• be a private school properly registered with the State of Alaska Department of Education.
Listed on an active college savings plan account with the UA College Savings Plan, T. Rowe Price College Savings Plan, or John Hancock
Freedom 529 Plan and have held the account for a minimum of two years prior to the current semester.
Student must move to and reside in Alaska, and remain continuously enrolled during their course of study.
IamaUnitedStatescitizenoreligiblenoncitizenand(exceptoptionC)IamdeclaringmyintenttoremaininAlaskaindefinitely.By submitting this
application, I certify that I am or will be an Alaska resident for tuition purposes, or that I qualify for the nonresident surcharge exemption, as defined in
BOR Policy P05.10.025 or P05.10.050.Iunderstandthatfailuretofilethisformpriortothe published deadline, in the semester for which residency is
sought, will waive any claim for resident tuition assessment in that semester or prior semesters.Applicantswithpriordocumented
begranteda60-dayextensiontotheabovestateddeadlinetoprovere-establishmentof their residency.
Ofce use only
Approved Denied By: Date:
Residency pending for the following documentation:
Initials: Date: Term: Fall 20 Spring 20 Summer 20 Late start (date)
University of Alaska Anchorage
3211 Providence Drive
University Center #106
Anchorage, AK 99508
Phone: (907) 786-1480
Fax: (907) 786-4888
Kenai Peninsula College
University of Alaska Fairbanks
University of Alaska Southeast
11066 Auke Lake Way
UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination.