Colorado National Guard Tuition Adjustment Form printable pdf download

Student Financial Services

Division of Enrollment and Access

Centennial Hall

1065 Campus Delivery

Fort Collins, Colorado 80523-1065

(970) 491-6321 (970) 491-5010 FAX

sfs.colostate.edu

COLORADO NATIONAL GUARD TUITION ADJUSTMENT FORM

Indicate the term for which you are requesting the Colorado National Guard Tuition Adjustment: Term

Year

Certification of this form must be signed by the Education Services Officer and submitted to Student Financial Services no earlier than

30 days prior to the first day of classes and no later than the first day of classes. Failure to submit this form by the first day of

classes may result in non-resident tuition classification for the semester without right to appeal. Colorado National Guard tuition

adjustment eligibility expires the first term following Colorado National Guard retirement/ discharge or loss of dependent status. The

student can obtain in-state tuition classification if they meet the requirements for Colorado domicile and submit a Petition for In-state

Tuition Classification to Student Financial Services by the semester deadline

Student’s Name:

Last

First

Middle

Former Name

Address

Street

City

State

Zip

___________________________

__________________

_____________________________

(______)

CSUID

Date of birth

E-mail

Daytime Phone Number

Sponsor’s Name: (if not student) Last

First

Middle

Former Name

Address

Street

City

State

Zip

(_______)

Daytime Phone Number

Relationship to Student

E-mail

Part I – To be Completed by the Education Services Officer

I certify that (name)

is a permanent duty member of the Colorado National Guard with

permanent duty station in (location)

and that (name of dependent)

is a legal dependent of this member. I further attest that the information certified above

will remain in effect as of the first day of classes for the requested semester at Colorado State University.

Education Services Officer:

Name

(Please print)

Title

(Please print)

Office or Command

Signature of Certifying Official

Date

Part II – Verification of Domicile

Complete the following questions for the Colorado National Guard member and attach all requested documentation to

support their Colorado domicile.

Dates of physical presence in Colorado, from ______-______-______ to ______-______-______

yyyy

Attach a copy of your lease, rent receipts, or warranty deed to support your physical presence in Colorado.

Years Colorado income tax filed: ________

________

Attach signed copies of your Colorado income tax return for last year filed.

Continued on next page

Colorado National Guard Tuition Adjustment Form

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