Midlands Technical College is in full compliance with the South Carolina Illegal Immigration Reform Act (section 59-101-430 of
the SC Code of Laws, As Amended). All students must provide proof of citizenship or lawful presence in the United States in
order to attend any public institution of higher education in South Carolina.
Name Student ID Number
I am: (check one): o A U.S. Citizen o Not a U.S. Citizen
Choose one (1) of the options below and submit documents to prove your status per the directions for that option. Only sign this form one
time in one section. Upon processing, if the documents do not satisfy verification requirements, a hold will be placed on your account and
you will not be allowed to register or perform other student transactions until verification is completed.
IMPORTANT: The name on all of your documents must match the name in our database. If your name has changed since birth and does not
match the documents you submit, you will also need to provide legal documents to justify all name changes. Such documents would include
a marriage certificate, divorce decree, court ordered name change, adoption record, and/or Certificate of Naturalization.
Submit this form and all documents together:
> In person at the Admissions Office at any Midlands Technical College campus OR
> By mail to: Midlands Technical College Admissions, PO Box 2408, Columbia, SC 29202 OR
> By email to: verify@midlandstech.edu. Forms submitted via email must be in a clear, scanned format (no photographs).
PROOF OF U.S. CITIZENSHIP – PUT AN “X” BY YOUR CHOICE
o Valid South Carolina driver’s license, CDL, DMV-issued photo ID, or beginner’s permit
o Birth Certificate issued in the United States (with birth/file number and registrar’s signature) by an official state
government agency AND a valid government-issued photo ID
o U.S. Passport; within 5 years of expiration
o Unexpired military ID
o Certificate of Naturalization or Certificate of Citizenship AND a valid government-issued photo ID
o U.S. government-issued Consular Report of Birth Abroad AND a valid government-issued photo ID
o Birth Certificate from a U.S. Territory (must be English translation) such as Puerto Rico, Guam, U.S. Virgin Islands, and
American Samoa AND a valid government-issued photo ID
o Valid driver’s license or ID from the following states (if your state is not on this list, it is not eligible): Alaska, Arizona,
Connecticut, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Maine (issued after 11/15/08), Maryland,
Massachusetts, Michigan, Missouri, Montana, New Hampshire, New Jersey, North Carolina, Pennsylvania, Rhode Island,
Tennessee, Texas, Virginia, West Virginia, or Wisconsin.
By my signature below, I hereby attest and certify, under penalty of perjury, that I am a citizen of the United States. I understand that federal
law makes it a crime, punishable by up to three years in prison, to falsely and willfully represent oneself to be a citizen of the United States.
Full, Handwritten Signature of Student Date
PLEASE SIGN WITH BLUE OR BLACK INK
PROOF OF US CITIZENSHIP – PUT AN “X” BY YOUR CHOICE
o Alien Registration Receipt card with photograph issued before June 1978
o Resident Alien card issued before 1997
o Permanent Resident Card with photograph issued after 1997 (scans/copies of both front and back required)
o USCIS paperwork or valid immigration status
o DACA recipients must submit their unexpired Employment Authorization Documents.
By my signature below, I hereby attest and certify that I am a non-U.S. citizen lawfully present in the United States.
Full, Handwritten Signature of Student Date
PLEASE SIGN WITH BLUE OR BLACK INK
(OFFICE USE ONLY)
Military ID - Enter in expiration date: __________ and your initials indicating you physically saw the document: _____
All other processors - Enter initials: _____
MIDLANDSTECH.EDU | PO BOX 2408 | COLUMBIA SC 29202 | 803.822.6714
ADMISSIONS
VERIFICATION OF LAWFUL PRESENCE
SD-19-5387-02-19