Texas Application For State Financial Aid (Tasfa) - 2016-2017 Page 4
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4Section VI: Statement of Selective Service Registration Status
41.
Certification of registration status (Please check the appropriate box.)
I certify that I am female and, therefore, not required to register with the Selective Service System.
I certify that I am a male age 18 to 25 and am registered with the Selective Service System.
Please attach copy of registration acknowledgement card.
I certify that I am not of an age required to register with Selective Service System. (That is, I am over 25.)
I certify that I have been determined by the Selective Service System to be exempt from registration.
I certify that I have not reached my 18th birthday and understand that I will be required by law to register at that time and will
provide proof of registration once I receive my Selective Service Registration Acknowledgement Card.
I certify that I do not have a Social Security Number, but have submitted my Selective Service registration form to the
Selective Service System and will provide proof of registration to the financial aid office as soon as I receive my registration number.
Section VII: Signatures
42.
a. Student and Parent signatures
I understand that under Texas Education Code, Section 51.9095, I must be registered with the Selective Service System according to the
requirements of federal law in order to receive student financial aid funds from the State of Texas, and hereby certify that I meet this
requirement. I also certify that I will use state student financial aid to pay only the cost of attending an institution of higher education,
and that the information provided on this form is true, complete, and correct to the best of my knowledge. I understand that any false
statements may void my eligibility for state financial aid. I also certify that the information provided on this form will be used only for
evaluation of eligibility for state financial aid and that I may need to provide additional information for my school to determine eligibility
for state financial aid.
Student signature
Date
Parent signature*
Date
(*Parent signature required only for dependent students)
b. High School Counselor: Not required if parent signature already provided above.
High school counselor signature
Date
Printed name
Title
Street address
City
State
ZIP code
Telephone
Email address
Print full name here:
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2016–2017 Texas Application for State Financial Aid
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