FINANCIAL AID OFFICE
Financial Aid Office * 96-045 Ala Ike Street * Pearl City, 96782
Phone: 808 455-0606 * Fax: 808 453-6371 * Website: www.leeward.hawaii.edu/finaid * MyUH Services: https://myuh.hawaii.edu
Rev. 04/2020
Selective Service Form
_____________________________________________ _____________________ _________________
Last Name First Name UH ID/Username Phone Number
Most male U.S. citizens and male immigrants, who are 18 through 25 years of age, are required to register with
Selective Service. Indicate your status below and provide the appropriate documentation.
I am registered with Selective Service Provide a copy of Selective Service Confirmation
I am exempt from registering with Selective Service because (select one status from the list below and provide
the appropriate documentation):
I am a female Provide a copy of original birth certificate or government-issued photo ID
Individuals who were born male and have changed their gender to female are required to
register
I have not reached my 18th birthday Provide a copy of original birth certificate or government-issued
photo ID. You must also answer ‘Yes Register Me’ to question 22 of the FAFSA.
I am a member of the Armed Forces on active duty Provide a copy of military orders
I am a veteran of the Armed Forces - Provide a copy of DD-214 form
I was born before 1960 Provide a copy of original birth certificate
I am a non-U.S. male who entered this country for the first time after my 26 birthday visit
https://www.sss.gov/Portals/0/PDFs/DocumentationList.pdf for a list of acceptable documentation
you may provide to our office.
I am a non-U.S. male on a valid non-immigrant visa visit
https://www.sss.gov/Portals/0/PDFs/DocumentationList.pdf for a list of acceptable documentation you
may provide to our office.
I was required to register with Selective Service, but did not. Submit BOTH of the following:
1. A statement explaining why you were unable to register, or why you did not know that males between
the ages of 18 to 25 are required to register with Selective Service.
2. A ‘Status Information Letter’ from the Selective Service System to show that you attempted to register
and are not allowed to. To get this letter, please go to:
www.sss.gov
Click on Men 26 and older’, then Status Information Letter Request Form.
Print out and complete form and mail to the Selective Service System (address is on page 2
of the form). You may also contact Selective Service by phone at 1-888-655-1825.
I certify that the information I attached is accurate and true to the best of my knowledge.
Student Signature: ___________________________________________________ Date: ___________________
Electronic signature or digital signature will NOT be accepted.
FINANCIAL AID OFFICE
Financial Aid Office * 96-045 Ala Ike Street * Pearl City, 96782
Phone: 808 455-0606 * Fax: 808 453-6371 * Website: www.leeward.hawaii.edu/finaid * MyUH Services: https://myuh.hawaii.edu
Rev. 04/2020
University of Hawai'i institutions do not discriminate on the bases of age, race, sex, color, national origin, or disability in its programs and
activities. For more information or inquiries regarding these policies, please contact the individual campus Title IX Coordinator. UH Title IX
Coordinators' names and contact information are available at: https://www.hawaii.edu/titleix/help/coordinator/
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