Residency Application Student Form
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4RESIDENCY APPLICATION
STUDENT FORM
This form is to be completed by students who are seeking to establish eligibility to pay the in-state rate on
tuition and fees at Clemson University. The form should be completed, signed, notarized and returned to the address
below no later than the day before classes begin for any semester for which the student is attempting to qualify to pay
the in-state rate on tuition and fees. Please note that a Parental/Spouse/Guardian form is also required for students
under 24 years of age in order to complete the application process.
Determination of residency status will be made on the basis of the South Carolina Code of Laws and regulatory
guidelines promulgated by the South Carolina Commission on Higher Education.
PLEASE RETURN THIS ORIGINAL FORM NOTARIZED TO: Office of Student Financial Aid
Clemson University
G-01 Sikes Hall
Clemson, SC 29634
Please check ONE of the following:
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Continuing Undergraduate Student
Incoming Freshman Student
Transfer Student
Graduate Student
PERSONAL INFORMATION
1. Applicant’s Name: ________________________________________________________________________________
LAST FIRST
MIDDLE
(Preferred)
2. Clemson University XID: _________________________ E-Mail Address: _________________________________
3. In what category are you requesting residency status? Please check ONE of the following:
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Independent Student
Dependent of: _____________________________ Relationship? ________________
4. Date of Birth: ______________________ Age: __________ Marital Status: ________________________________
5. Phone where you can be reached: _______________________ Can a message be left at this number? __________
6. Address: Present ___________________________________________(how long have you lived here) ____________
Permanent____________________________________________________________________________
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Do you, the student, own the home in which you presently live?
YES
NO
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Do you, the student, rent the home in which you presently live?
YES
NO
List all addresses where you have lived during the past two years and the date you lived at each (not including the above
address).
ADDRESS
DATES
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
7. For what semester are you requesting in-state tuition to begin? ___________________________________________
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8. Have you applied for in-state tuition before?
YES
NO If yes, When? ______________________________
OFFICE OF RESIDENCY CLASSIFICATION
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