CONTINUED ON REVERSE
revised 2.4.19_vlj
Selective Service Form
STUDENT NAME: _______________________________________________ WCC ID #: ___________________________
Federal law requires all men 18 years or older and born after December 31, 1959 to register with the Selective Service
System to be eligible for federal student aid, unless they meet certain exemptions. The Department of Education was not
able to verify your registration or exemption when you completed the FAFSA. As a result, you are required to provide
written documentation as proof of your registration or exemption status. *This issue must be resolved before your
request for financial aid can be processed.
INSTRUCTIONS: Complete this worksheet, attach any applicable documentation, sign, and submit the completed
package to the WCC Financial Aid Office for review.
CHECK THE APPROPRIATE BOX BELOW ACCEPTABLE DOCUMENTATION
I am between the ages of 18 25 and have not yet
registered with Selective Service; please use my
FAFSA information to register me.
Sign and date the back of this form and return to the
WCC Financial Aid Office.
I am registered with the Selective Service System.
Copy of the Selective Service Registration card OR
an Official Letter of Verification.
(available at
www.sss.gov)
I have not reached my 18
th
birthday.
A valid government
-issued document showing your date
of birth.
(Examples: state-issued ID card, driver’s license,
passport, or birth
certificate)
I am a female and/or I was born a female.
Make corrections to item # 21 at
fafsa.gov OR submit a
copy of your birth certificate.
I am currently serving on active duty in the U.S.
Armed Forces.
Copy of your current full
-time active duty orders OR your
most recent LES
.
I am a Veteran who is 26 years of age or older
and served in the U.S. Armed Forces,
excluding the Reserves, National Guard or
Delayed Entry pool.
Copy of your DD Form 214, “Certificate of Release or
Discharge from Active Duty.”
I was not able to register because I was
hospitalized, incarcerated, and/or institutionalized
before the age of 18 and remained confined
through my 26
th
birthday.
Hospitalization, incarceration, or institutional
records documenting the length of confinement.
I am a non-U.S. male who first entered this
country after my 26
th
birthday.
Passport with a date of entry stamp, I-94 with date
of entry stamp or a letter from the U.S. Citizenship
and Immigration Services (USCIS) indicating the
date you entered the U.S.
I am a non-U.S. male in this country on a valid
non-immigrant visa.
Copy of your I
-20 form OR a letter from a school you
attended on an F
-1 Student Visa indicating your full-time
attendance as a non
-immigrant alien.
RETURN THIS COMPLETED FORM WITH REQUIRED DOCUMENTATION TO:
Wayne Community College Financial Aid Office PO Box 8002 Goldsboro, NC 27533-8002
FAX: 919-736-9425
Wayne Community College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate degrees. Contact the
Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Wayne Community College.
The Commission on Colleges may be contacted only if there is evidence that Wayne Community College is significantly non-compliant with a requirement or standard.
Accreditation standards are located at: http://www.sacscoc.org/principles.asp. Inquiries about Wayne Community College, such as admission requirements, financial aid,
educational programs, etc. should be addressed directly to Wayne Community College and not the Commission’s office.
I am a citizen of the Federal States of Micronesia, or
the Republic of the Marshall Islands, or the Republic
of Palau and have not lived in the U.S. for more than
one year for any reason except as a student or
employee of the government of my homeland.
I did not register with the Selective Service System
and am now ineligible to register because I am I
have reached my 26
th
birthday. Furthermore, I am
not able to provide documentation of any exemption
mentioned in the options above.
STATUS INFORMATION LETTER provided
(This letter is available
www.sss.gov or by calling 1-847-688-6888.) AND
explaining why you did not
25.
I have provided the STATUS INFORMATION
LETTER AND written statement in a previous year
and believe both should be on file in the WCC
Financial Aid Office.
previously submitted?
CERTIFICATION AND SIGNATURE
By signing below, I certify that the information provided to document my Selective Service registration status is true and complete.
STUDENT’S SIGNATURE (REQUIRED) DATE
AN INCOMPLETE OR UNSIGNED FORM WILL DELAY PROCESSING OF YOUR FINANCIAL AID REQUEST
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome