Residency Questionnaire Form PDF Details

Understanding the pivotal role of the Residency Questionnaire form is crucial for prospective students at UNCG (University of North Carolina at Greensboro), aiming to secure in-state tuition status. This document, vital for all North Carolina residents, serves as a comprehensive tool to assess eligibility for reduced tuition rates versus the significantly higher out-of-state charges. Applicants are instructed to return the completed form through email, postal mail, or SpartanLink upload, being mindful that any omissions or incomplete answers could not only delay the admissions decision but also default their status to that of a non-resident, thereby affecting tuition fees. The form delves into an array of personal information including, but not limited to, full legal name, birth details, various addresses, employment history, and any military affiliations, with a strict admonition against faxed submissions. Additionally, specific sections inquire about the applicant's driving licensure and recent tax exemption claims to meticulously verify the residency claim. Emphasizing instructions like the importance of answering every question and the need for providing information as accurately as possible, the form underscores the critical nature of honesty and transparency in the process. It closes with a student residency agreement highlighting the implications of incomplete or inaccurate submissions, reminding applicants that the submission of this form is a step in a process that might require further validation of their residency claims.

QuestionAnswer
Form NameResidency Questionnaire Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesresidency questionnaire form, north short form, uncg residency, uncg form

Form Preview Example

UNCG

North Carolina Residency Questionnaire (Short Form)

The following information is required for all NC Residents.

Return to:

UNCG - Undergraduate Admissions PO Box 26170

Greensboro, NC 27402

E-mail to admissions@uncg.edu or

Upload it in Spartanlink

NOTE: Failure to complete this form in full will delay notification of an admission decision and will result in a non-resident classification for tuition purposes (you will be charged the out-of-state tuition rate). If you have any

questions about your residency, please contact Undergraduate Admissions at (336) 334-5243.

Instructions:

Answer all questions completely. Print clearly in ink or type. Do not leave any spaces blank. If questions do not apply to you, please write “N/A” – omitted information may result in a non-resident classification for tuition purposes. Please submit this form to Undergraduate Admissions in one of the three ways described above. Faxed copies are not accepted.

Full Legal Name ___________________________________________________________________________________________________________

1.Date of Birth ______/______/______ Place of Birth _________________________________ Citizenship ____________________ Sex ______

mo.

day

yr.

2.Permanent Address (Street) ______________________________________________________________________________________________

(City, State, Zip) ____________________________________________________________________________________ Since ___/_____/_____

mo. day

yr.

.

 

3.Current Mailing Address (Street) _________________________________________________________________________________________

(City, State, Zip )__________________________________________________________________________________ Since _____/_____/_____

 

mo. day

yr.

4. Current Telephone (______)_______________________

E-mail ____________________________________________________________

5.Previous Address (Street) ________________________________________________________________________________________________

(City, State, Zip )_________________________________________________________________ From ____/____/____ Until ____/____/____

mo. day yr.

mo. day

yr.

6.Last Address Outside NC (Street) _________________________________________________________________________________________

(City, State, Zip )__________________________________________________________________ From ____/____/____ Until ____/____/____

mo. day yr. mo. day yr.

8. Do you claim to be a legal resident of North Carolina for the last 12 months for tuition purposes?

Yes

No

If “yes,” please complete the rest of the information below.

9.Driver’s license acquired: When______________(month/year) Where______________(state)

Driver’s license renewed: When______________(month/year) Where______________(state)

10. Have you been in active military service or have you been a military dependent in the past 12 months? Yes No

If “yes, ” attach to this application copies of the “Leave and Earnings Statement” for the most recent pay period and for the pay period 12 months ago for each such person.

11. Have you ever worked outside of North Carolina?

Yes

No

NAME _____________________________________________________________________________________________

PAGE 2

12. Please list ALL of your employment for wages in the past 24 months (include a separate sheet if needed):

Job Title EmployerAddress (City, State)From (mo./yr.) To (mo./yr.) Hrs/Week

__________________________________________________________________ ________/___________/____________/___________

__________________________________________________________________________/____________/____________/___________

__________________________________________________________________________/____________/____________/___________

__________________________________________________________________________/____________/____________/___________

Parent / Guardian Information:

 

13. Is your father living? Yes No

Father’s Name _____________________________________________________

Current Address (Street) ________________________________________________________________________________________________

(City, State, Zip) _________________________________________________________________________________ Since _____/_____/_____

mo.

day

yr.

Previous Address (Street) _______________________________________________________________________________________________

(City, State, Zip )________________________________________________________________ From ____/____/____ Until ____/____/____

mo. day yr.

mo. day yr.

State of Legal Residence ______________________________________________________________ Since (mo./ day/ yr.)

____/____/____

Employer ___________________________________________________________________________________________________________

Occupation ___________________________________________ Location (City, State) __________________________________________

Highest Education Level Completed (or degree received) ________________________________________________________

Is your father a UNCG graduate? Yes No

14. Is your mother living? Yes No Mother’s Name ___________________________________________________

Current Address (Street) _______________________________________________________________________________________________

(City, State, Zip) ________________________________________________________________________________ Since _____/_____/_____

mo. day

yr.

Previous Address (Street) ______________________________________________________________________________________________

(City, State, Zip )_______________________________________________________________ From ____/____/____ Until ____/____/____

mo. day yr. mo. day yr.

State of Legal Residence ______________________________________________________________ Since (mo./ day/ yr.) ____/____/____

Employer __________________________________________________________________________________________________________

Occupation __________________________________________ Location (City, State) _________________________________________

Highest Education Level Completed (or degree received) ________________________________________________________

Is your mother a UNCG graduate? Yes No

NAME ____________________________________________________________________________________________ PAGE 3

15. Are your parents separated or divorced? Yes No If yes, who has legal custody? _______________________________

16.Guardian Name (if not living with parents) _________________________________________________________________________

Current Address (Street) _______________________________________________________________________________________________

(City, State, Zip) ________________________________________________________________________________ Since _____/_____/_____

mo. day

yr.

Previous Address (Street) ______________________________________________________________________________________________

(City, State, Zip )_______________________________________________________________ From ____/____/____ Until ____/____/____

mo. day yr.

mo. day yr.

State of Legal Residence ______________________________________________________________ Since (mo./ day/ yr)

____/____/____

Employer ___________________________________________________________________________________________________________

Occupation ___________________________________________ Location (City, State) __________________________________________

Highest Education Level Completed (or degree received) ________________________________________________________

Tax Information:

17.A: Did you claim yourself as an exemption on income tax returns last year?

(if you filed your own taxes and no one else claimed you, check “yes”)Yes No

If “yes,” in what state did you file? ____________________________________________________________________

B:If someone else claimed you on his/her income taxes, please provide the following information: Who last claimed you as a dependent or exemption on income tax returns?

Name _______________________________________________________________________________________________

Relationship ______________________________ Tax Year _____________ State filed _______________________

C:Do you intend to claim yourself as an exemption on income tax returns for the current year?

(if you intend to file your own taxes and no one else will claim you, check “yes”) Yes No

If “yes,” in what state do you intend to file? _____________________________________________________________

D:If someone else intends to claim you as a dependent or exemption on income tax returns for the current year, please provide the following information:

Name _______________________________________________________________________________________________

Relationship _____________________________ Tax Year ____________ State to be filed ___________________

NAME ______________________________________________________________________________________________ PAGE 4

18. Student Residency Agreement:

_____ I have answered all questions. If any questions were not applicable to my situation, I have written “N/A”. Whenever dates are

Initials requested, I have given month/day/year as accurately as possible. I understand that failure to answer all questions may result in being classified as an out-of-state resident for tuition purposes.

_____ I certify that the responses provided are true and complete to the best of my knowledge. I understand my failure to provide

Initials complete, accurate, and truthful information will be grounds to deny or withdraw my admission or dismiss me after enrollment.

_____ I understand that submission of this form does not guarantee a classification of in-state residency and that I might be asked for

Initials additional information in support of my claim to the in-state tuition benefit.

_____ I also agree to inform the Office of Undergraduate Admissions, in writing, of any change of address or residency.

Initials

_____ I understand that if I do not attend UNCG, discontinue my enrollment at UNCG at any time, or do not complete my admissions

Initials application, I will be required to re-apply and re-submit my residency information.

___________________________________________________________________

______/______/______

Signature of Applicant

Date (month/day/year

Additional Information:

(Please use this space or attach a separate sheet for any additional information or explanation pertaining to your residency.)

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