Application For Classification As A Legal Resident - Wayne Community College
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1
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3WAYNE COMMUNITY COLLEGE
APPLICATION FOR CLASSIFICATION AS A LEGAL RESIDENT
OF NORTH CAROLINA FOR TUITION PURPOSES (PART II)
Under North Carolina law, bona fi de legal residents (domiciliaries) of North Carolina are eligible for a lower tuition rate than non-
residents. Copies of the applicable law and of implementing regulations are available for inspection in the Learning Resource Center.
In essence, the controlling North Carolina statute (G.S. 116-143.1) requires: “To qualify as a resident for tuition purposes, a person
must have established legal residence (domicile) in North Carolina and maintained that legal residence for at least 12 months immedi-
ately prior to his or her classifi cation as a resident for tuition purposes.” G.S. 116-143.1 also sets forth statutory defi nitions, rules, and
special provisions for determining resident status for tuition purposes.
DIRECTIONS
1.
Answer all questions. Incomplete forms will be returned. If any question is not applicable to your own situation, write “not applicable.”
2.
Print or type all responses. If you need more space to answer, write “see attached” in the space provided, and use separate additional sheets,
numbering your responses the same as the corresponding question and stapling or taping these sheets to this application form.
3.
Be completely accurate to the best of your knowledge and understanding. Knowing falsifi cation of your responses may subject you to disciplinary
action including dismissal from the College. When “Date” is requested, give month, day, and year.
4.
Sign and date this application where indicated to make those acknowledgments and certifi cations necessary to render this a viable application.
TYPE OR PRINT ALL RESPONSES IN BLACK INK OR DARK PENCIL
1.
Applicant (student’s) full name _____________________________________________ Social Security No.(Voluntary)______________________
Last
First
Middle/Former
2.
Date of birth _____________________________ Place of birth _________________________________________________________________
3.
Are you currently enrolled in Wayne Community College?
Yes
No
Are you applying for admission?
Yes
No
4.
Secondary (high or preparatory) schools you attended in sequence:
Dates attended
Name
Address (city & state)
(from)
(to)
a) ___________________________________
__________________________________________
_____________ ____________
b) ___________________________________ ________________________________________ __
_____ ________ ____________
5.
Post-secondary schools (universities, colleges, junior colleges, community colleges, etc.) you have attended, in sequence (including WCC):
Dates attended
Name
Address (city & state)
(from)
(to)
a) ___________________________________
__________________________________________
_____________ ____________
b) ___________________________________ ________________________________________ __
_____ ________ ____________
If married, post-secondary schools (universities, colleges, junior colleges, community colleges, etc.) your spouse has attended, in sequence
(including WCC):
Dates attended
Name
Address (city & state)
(from)
(to)
a) ___________________________________
__________________________________________
_____________ ____________
b) ___________________________________ ________________________________________ __
_____ ________ ____________
6.
If you have applied previously for a determination of your residence status for tuition purposes to any N.C. public college or university, for each:
a)
give name of college or university _____________________________________________________________________________________
b)
if your residence status was determined, circle classifi cation:
Resident
Non-Resident
7.
Why and when did you move your home to North Carolina? (reason) _____________________________________________________________
______________________________________________________________________________________________ (date) ________________
8.
When and from what state or foreign country did you move your home and legal residence to North Carolina?
Moved from ______________________________________________________________________________ On (date)___________________
9.
When do you claim that you began your legal residence (domicile) in North Carolina? (date) __________________________________________
10.
Your marital status:
single_____/
married _____(date)__________________/
divorced _____(date)______________________/
separated _____ (date) _______________/ legal separation ______ (date) ______________/ widowed _____(date)__________________/
marriage annulled _____ (date)_________________/
11.
Who, including yourself, last claimed you as an exemption on state and/or Federal income tax returns, for what tax year, and in what state fi led?
a) On state return for __________tax year, fi led in (state) _____________________________________________________________________
Name _______________________________________________________________ Relationship to you ____________________________
b) On Federal return for _______tax year, fi led in (state) _____________________________________________________________________
Name _______________________________________________________________ Relationship to you ____________________________
c) Is it the present intention of anyone (including yourself) to claim you as a dependent on State and/or Federal income tax returns for the current
tax year?
Yes
No
If so, who? _____________________________________ Relationship to you _________________
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