Application For Out-Of-State Tuition For Military Personnel And Their Dependents Form printable pdf download

Application For Out-Of-State Tuition For Military Personnel And Their Dependents Form

COLUMBUS STATE UNIVERSITY

APPLICATION FOR OUT-OF-STATE TUITION

FOR MILITARY PERSONNEL AND THEIR DEPENDENTS

Section I – To be completed by the STUDENT

Student name: ____________________________________________________________Student ID: ________________________

Address: _________________________________________________________________________________________________

Email: __________________________________________________________________Phone: ___________________________

Please select which of the following apply:

I am an active duty military member

2. I am a dependent of an active duty military member and

A-Currently stationed in or assigned to GA.

A-My military sponsor is currently stationed in or assigned

to GA.

B-Previously stationed in or assigned to GA but currently

B-My military sponsor was previously stationed in or as-

reassigned outside of GA.

signed to GA but has been reassigned outside of GA.

Section II –Required Documentation

Active Duty military members must submit:

Dependents (child/spouse) of Active Duty military must submit:

• Copy of Military orders showing active duty

• Copy of Active Duty Military members current orders showing active duty

stationed in Georgia

AND

• Presentation of Active Military ID (must be

• Presentation of Dependent Military ID (must be presented in person) If you

presented in person) If you are unable to present

are unable to present your card, send DD1172 (DEERS form)

your card, send your DD1172 (DEERS Form).

For Office Use Only

Military Member Sponsor ________________________________________________________

Active Duty

Military ID received by __________________________________________________________

Signature of CSU employee

Date

Title

Dependent

ID card expiration date __________________________________________________________

Title 18, US Code Part 1, Chapter 33, Section 701 (official badges, identification cards, other insignia) prohibits the act of copying a

United States military identification card.

REV 11.13

Index Code: MIWV

Application For Out-Of-State Tuition For Military Personnel And Their Dependents Form