Selective Service Verification Form
Your financial aid application cannot be processed at this time because your Selective Service Registration cannot be confirmed. Please
complete this
Selective Service Verification Form and submit it with the requested document(s) listed below for review. If you have any
questions, please contact your GCU Student Services Counselor.
Please check the box that applies to you and provide document(s) for each
marked statement:
I was assigned the sex of female at birth (Please provide a copy of your birth certificate. If your current legal
name is different from the name that appears on your birth certificate, please provide proof of name change.)
I was born before 1960 (Please make the correction on your Student Aid Report if Date of
Birth listed is incorrect or submit a copy of your driver license or state issued ID with your DOB listed)
I am currently in the armed services and on active duty (this exception does not apply to members of
the Reserve and National Guard who are not on active duty (Please provide a copy of one of the
following: Leave and Earnings Statement, Military Orders, Military Personal Record, or Letter from
Commanding Officer ))
I am a citizen of the Republic of Palau, the Republic of the Marshall Islands, or the Federated States
of Micronesia (Please provide a copy of your passport)
I was unable to register due to being hospitalized, incarcerated, or institutionalized for the entire
time between the ages of 18 to 26 (Please provide a signed and dated explanation on a separate
sheet and submit it with this verification form)
I was unable to register because I was enrolled in an officer procurement program at The Citadel,
North Georgia College and State University, Norwich University, Virginia Military Institute,
Texas A&M University, or Virginia Polytechnic and State University for the entire time between
the ages of 18 to 26 (Please provide documentation of your entire enrollment)
I first entered the U.S. after the age 26 (Please provide a copy of your stamped I-94 or U.S. Visa with
all pages of passport)
If none of the above applies to you and you were exempt from registering with Selective Service,
please provide a copy of your Status Information Letter
You must sign this
verification form certifying that the information you have chosen and/or provided is true
and accurate. Providing misleading and/or false information on this form may lead to fines, jail sentencing, or
both. Handwritten signature is required; typed/electronic signature is not accepted.
Student Name: ________________________________
Student Signature: _____________________________
GCU Student Number: ____________________
Date: ___________________________________
To be completed by the student
P0208202020
