Admission Form - Technical Education Center Osceola Page 3
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4THE SCHOOL DISTRICT OF OSCEOLA COUNTY, FLORIDA
TECHNICAL EDUCATIONCENTER OSCEOLA
ADMISSION FORM
FLORIDA RESIDENT FOR TUITION AFFIDAVIT
Read residency classification information before completing this form.
Student Name:
SS#:
DOB:
CHECK THE ONE STATUS THAT DESCRIBES YOUR SITUATION
I am an independent person who has maintained legal residence in Florida for at least 12 consecutive months.
I am a dependent person and my parent/legal guardian has maintained legal residence in Florida for at least 12 consecutive months.
I am a dependent person who has resided for five years with an adult relative other than parent/legal guardian and my relative has
maintained legal residence in Florida for at least 12 consecutive months.
(Attach a notarized verification letter from the relative stating that you have
resided with them for five years and attach copies of their most recent tax return, showing you are their dependent. Relative must complete residency information.)
I am married to a person who has maintained legal residence in Florida for at least 12 consecutive months, intend to make Florida my
permanent home, and relinquish my legal ties to any other state.
(Copy of marriage certificate required, spouse must complete residency information.)
I was previously enrolled at a Florida state institution and classified as a Florida resident for tuition purposes. I abandoned my Florida
domicile less than 12 consecutive months ago, and I am now re‐establishing Florida legal residence.
(Verification of pervious enrollment as resident
required.)
I, my parent/legal guardian, or spouse is an active duty member of the Armed Forces of the U.S. residing or stationed in Florida; is an
active duty member of the Florida National Guard who qualifies under 250.10(7) and (8); or is a military personnel not stationed in
Florida whose home of record or state of legal residence certificate, DD Form 2058, is Florida.
(Military/ National Guard documents or DD 2058 req.)
I, my parent/guardian, or spouse is living on the Isthmus of Panama and have completed 12 consecutive months of college work at the FSU
Panama Canal Branch.
(College transcript required; if spouse or child, copy of marriage certificate or proof of dependency also required.)
I, my parent/guardian, or spouse is a full‐time instructional or administrative personnel employed by the Florida State public school
system, community colleges, and/or institution of higher education.
(Fulltime employment verification on letterhead required.)
I am from Latin America/Caribbean and received a scholarship from the federal/state government.
(Scholarship required, must attend fulltime.)
I am a full‐time employee of a state agency or political subdivision of the state whose student fees are paid by the state agency or political
subdivision for the purpose of job‐related law enforcement or corrections training.
(Verification on letterhead required.)
I am a qualified beneficiary under the terms of the Florida Pre‐Paid Program.
(Copy of student’s signed PrePaid card and photo ID required.)
I am a permanent resident or other statuses granted indefinite stay and have maintained a domicile in Florida for at least 12 consecutive
months.
(United States Citizenship and Immigration Services (USCIS) documentation and proof of Florida residency required.)
I qualify under another Florida resident exemption not listed above.
(Please provide documentation to support your status.)
None of the above applies. I do not qualify as a Florida resident for tuition purposes.
PERSON CLAIMING RESIDENCY MUST COMPLETE THIS SECTION IN FULL
Two forms of documentation are required; one document must be from the First Tier. All documents are subject to verification; additional
documents may be requested. Documents must evidence the 12 month qualifying period. Florida Driver’s License/ID, voter, and vehicle
documentation requested below are preferred but not required; please see list of other acceptable residency documents.
Name of Claimant:
Relationship to Student:
Claimant’s Legal Address:
Phone:
Claimant is a U.S. Citizen:
Yes No If no, country of citizenship
Claimant’s FL Driver’s License/ID #:
Issue Date:
Exp. Date:
(Include Copy)
Claimant’s FL Voter Registration #:
Issue Date:
(Include Copy)
Claimant’s FL Vehicle Tag #:
Issue Date:
Exp. Date:
(Include Copy)
*Other Acceptable Residency Document:
(Include Copy)
*Other Acceptable Residency Document:
(Include Copy)
I do hereby swear and affirm that the above named student meets all requirements indicated in the checked category above for classification as a
Florida resident for tuition purposes. I understand that if false or fraudulent statements are submitted in connection with documentation to
establish residency, tuition and fees will be recalculated at the nonresidency rate, student will be responsible for paying additional monies due,
and will subject me to penalties for making a false statement pursuant to 837.06, Florida Statutes. I understand that this Statement of Florida
Residency and all supporting documents must be submitted prior to the first day of classes of the term/semester for which Florida residency is
sought.
Signature of Claimant
Date
Signature of Student (If not claimant)
Date
FOR OFFICE USE ONLY:
Approved
Denied
Verified By:
Date:
An Equal Opportunity Agency
Page 3 of 4
FC‐350‐2462 (Rev. 11/16/11)
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