Application For Instate Tuition - Old Dominion University
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1
2Return To
: Office of the University Registrar
Old Dominion University
1009 Rollins Hall, Norfolk, VA 23529
Application for
FAX: 757‐683‐5357 Phone: 757‐683‐4425
Virginia In-State Tuition
Email: instate@odu.edu
This form must be completed if you are claiming entitlement to in‐state tuition benefits pursuant to Section 23‐7.4 of the Code of Virginia.
Supporting documents and additional information may be requested.
You MUST complete, sign, and submit this form before the first day of classes of the term for which you are applying.
All questions must be answered. Incomplete/unsigned applications will experience delay in processing.
SECTION A: APPLICANT (you, the student)
Term for which you are applying for Virginia Status:
Fall
Spring
Summer
Year: 20______
Application Status:
First application for Virginia Instate Tuition
Applying to be reclassified
Name:
(Last Name, First Name, Middle Name or Initial)
Date of Birth: __________ University ID Number: ________________________ Social Security Number: _________________________
(if known)
(optional – for Federal reporting purposes)
: ________________________
Email Address: _____________________________
Daytime Phone
CURRENT ADDRESS
From (mm/yy): ________
Street Address: _____________________________________________________________________________
To (mm/yy) _________
City, State, Zip ______________________________________________________________________________
Country __________________________________________
PREVIOUS ADDRESS
(Only necessary if you have lived at your current address less than two years.)
From (mm/yy): ________
Street Address: _____________________________________________________________________________
To (mm/yy) _________
City, State, Zip _____________________________________________________________________________
Country __________________________________________
1.
How long have you lived in Virginia?
More than 365 days
Less than 365 days
STOP!
If Less than 365 Days . . .
. . .
You are NOT eligible for Virginia in-state tuition .
Please sign and date below and return form to the Office of the Registrar.
If 365 days or more . . . Continue to Question 2.
2.
Do you (the student) wish to claim in-state tuition rates based on your residency status in Virginia?
YES . . . Continue to Question 3.
STOP!
NO . . .
. . . Please sign and date below, and return form to the Office of the Registrar.
By answering “NO,” you are choosing not to apply for in-state tuition rates and will be charged out-of-state
tuition.
3.
Citizenship:
U.S.
Permanent Resident
Non-U.S. Citizen
If non-U.S. citizen, please specify Visa Type _________
Exp. Date ___________ ( please provide copy of I-94)
4.
Are you (the student) a non-U.S. citizen with one of the following visa classifications: F-1, J-1, or Undocumented (no visa and not a
U.S. citizen or permanent resident)?
YES . . . STOP!
You are NOT eligible for Virginia in-state tuition privileges. Please sign below and return form.
NO . . . Continue to Question
5.
5.
Are you (the student) a military dependent or are you on active duty with the military?
NO . . . Continue to Section B.
YES . . .STOP!
Please sign, date, and return this form along with the Active Duty
OR
Military Dependent Tuition Benefit Forms you
will find at the link below. Return all forms with requested documentation. Your tuition status will be determined based upon the
information you provide. Until then, your account will display out-of-state tuition rates.
1 (rev. June 2016)
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