University Of Alaska Application For Resident Tuition Assessment Form

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University of Alaska
Application for Resident Tuition Assessment
P
Complete this form to apply for resident tuition assessment and if you plan to enroll in more than 4 credits a semester. Submit it along with
supporting documentation to the appropriate campus office prior to the published deadline to add or drop regular semester-length courses in the
semester for which residency is sought.
Last
First
Middle Initial
UA ID No.
Mailing Address
Phone No.
Email Address
City
State
Zip
Term for which resident tuition is first requested:
Fall 20
Spring 20
Summer 20
Birthdate
(MM/DD/YYYY)
Late Start Class Begins:
(Start Date MM/DD/YYYY)
 OPTION A
Proof of Permanent Fund Dividend Eligibility
Your answer to ALL of the following criteria must be yes to qualify under option A. Documentation of State of Alaska Permanent
Fund Dividend (PFD) eligibility or receipt must be attached to this form.
I am eligible for resident tuition assessment because I:
1. Received or was qualified* to receive an Alaska Permanent Fund Dividend by the State of Alaska Permanent Fund Dividend Division
within the last 12 months; and
2. Can certify that I have been in Alaska for the past 12 months; and
3. Declare my intent to remain in Alaska indefinitely.
In the past two years, I have NOT:
• Been absent from Alaska for an aggregate of more than 120 days other than documented absences due to illness, or attendance at
another educational institution while maintaining Alaska residency;
• Acted inconsistently with Alaska residency, such as claiming residency in another state or voting as a resident of another state;
• Registered as a resident in an educational institution in another state; or
• Paid tuition at the University of Alaska at the Western Undergraduate Exchange (WUE) program rate.
*The term “qualified” in item 1 above refers to an individual’s eligibility for the PFD distributed within the last 12 months, even though the PFD may have been garnished or
withheld from the recipient. Proof of PFD distribution or eligibility (not just proof of PFD application) is required prior to the published end of the add/drop period for regular
semester-length courses for the semester in which residency is sought.
 OPTION B
Proof of Physical Presence
Your answer to ONE of the following criteria must be yes to qualify under option B, and all documentation must be attached to this
form. Note: additional information may be required to support your claim.
I am eligible for resident tuition assessment because I have been physically present in Alaska for two or more years and I am
supplying:
Documentation that I moved my household goods to Alaska prior to two years ago; or
Documentation of my lease, rental, or ownership of real property in Alaska for at least the prior two years; or
Documentation of my permanent employment in Alaska for at least the prior two years; or
Other indicia of Alaska residency for the two prior years deemed satisfactory by the chief enrollment officer or designee.
In the past two years, I have NOT:
• Been absent from Alaska for an aggregate of more than 120 days, other than documented absences due to illness or attendance at
another educational institution while maintaining Alaska residency;
• Acted inconsistently with Alaska residency, such as claiming residency in another state, obtaining a driver’s license from another state, or
voting as a resident of another state;
• Registered as a resident in an educational institution in another state; or
• Paid tuition at the University of Alaska at the Western Undergraduate Exchange (WUE) program rate.
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