Selective Service Resolution
2017-2018
Student ID
___________________________________________________ _____________________________________________
Last N
ame
Fi
rst Name
Current Federal law requires that males ages 18-25 register with the Selective Service System to receive federal Student
a
i
d. Since Selective Service has not been able to confirm your registration or your exception status, please indicate which
statement applies to you and return this form along with supporting documents to the Office of Financial A
i
d.
_______I a
m exempt from reg
i
ster
i
ng w
i
th Se
l
ect
i
ve Serv
i
ce because:
I a
m Female
I was born before 1960
I am under the age of 18
I am a noncitizen male who first entered the US after my 26
th
birthday. Please submit a copy of your
passport or I-94 Departure Record with Date of Entry Stamp. Please note: if you entered the country i
ll
egally
after your 26
th
birthday, you must provide proof that you were not in the US from ages 18
---
25. Your Res
i
dent
Al
i
en Card
i
s not va
li
d as proof of Date of Entry
.
I am a nonc
i
t
i
zen who entered the US as a
l
awfu
l
non
i
mm
i
grant on a val
i
d V
i
sa and remained on that status
after my 26
th
birthday
.
P
l
ease subm
i
t a copy of your I
---
20 form
.
I am a Veteran or currently in the armed forces and on full time active duty. Please submit a copy of your
DD-214 or current fu
ll
t
i
me act
i
ve duty orders
.
______I have already registered with Selective Service with my legal name, date of birth, and my social security number.
Ple
ase subm
i
t a copy of your Select
i
ve Serv
i
ce Reg
i
strat
i
on Acknow
l
edgment Card or On
li
ne Reg
i
strat
i
on Ver
i
f
i
cat
i
on
.
I am over the age of 26, failed to register with Selective Service, and do not meet any of the above criteria. I
understand that I must contact Selective Service to request a ‘Status Information Letter’, which will include my
information regarding the status of my eligibility. I can expect a response from Selective Service by mail within 90 days
of my request. I further understand that I must submit a copy of the Status Information Letter along with a signed
written explanation for not registering with Selective Service to the Office of Financial Aid along with supporting
documentat
i
on as required. Documentat
i
on Required:
____Copy of Se
l
ect
i
ve Serv
i
ce ‘Status Informat
i
on Letter’
____Student’s s
i
gned Statement/Exp
l
anat
i
on for not reg
i
ster
i
ng w
i
th Se
l
ect
i
ve Serv
i
ce
I understand that by signing this form I agree, if asked, to provide information that will verify the accuracy of the completed form.
Also, I certify that I understand that Pasadena City College’s Office of Financial Aid has the authority to verify information reported
on this application with other federal agencies. I further understand that if I purposely give false or misleading information I may
be fined up to $20,000.00, sent to prison, or both.
Student’s Signature
Date
1570 East Colorado Blvd., Pasadena, California 91106
---
2003
18SLSV
