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2016-2017 Selective Service Registration Status Form The United States Division of Selective Service has not confirmed your registration or exemption status. Therefore, Federal Government is requiring that we obtain verification from you of your selective service registration status. Bring this completed and signed form to the Answer Center with the appropriate documentation if applicable The Office of Financial Aid Services will compare your FAFSA with the information on this form and with any other required documents (This takes a minimum of 7 to 10 business days).
A. Student Information ____________________________________________________________________ Last Name First Name M.I. ___________________________ Home Phone (Including Area Code)
___________________________ Valencia ID#
_____________________________ Date of Birth
B. Statement of Selective Service Registration Status (Check one) □
I am registered with Selective Service. My Selective Service # is ________________________________________ You can obtain verification of your registration status by logging into the Selective Service web page at www.sss.gov or by calling 1-847-688-6888.
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I am not registered, but I have received a Status Letter from Selective Service. Attach a copy of your Status Letter. If your Status Letter states that you were required to register but failed to do so, please attach an explanation of why you did not register.
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I am currently in the U.S. Armed Forces and on active duty (this exception does not apply to members of the Reserve and National Guard who are not on active duty). Attach a letter from your commanding officer documenting your active duty status.
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I am a veteran of active duty in the U.S. Armed Forces (do not count Guard or Reserves). Attach a copy of your letter of discharge (DD214). If you need to obtain a copy of your DD214, please call the Veterans Administration at 1-800-827-1000.
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I was born before January 1, 1960.
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I am a citizen of one of the following: Republic of Palau; Republic of the Marshall Islands or the Federated States of Micronesia.
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I am or was a noncitizen who first entered the U.S. after I turned 26 and I am not required to register. Attach documentation of your immigration entry date into the U.S. from ONE of the following: a) I-94 form b) Dated passport immigration stamp entry documenting when you immigrated to the U.S. c) Letter from the U.S. Citizenship and Immigration Services (USCIS) indicating your entry date
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I am or was a noncitizen who entered the U.S. as a lawful non-immigrant on a valid visa and remained in the U.S. on the terms of that visa until after I turned 26. Attach documentation of Immigration entry date into the U.S. prior to age 26 from ONE of the following: a) A date stamp on your I-94 form b) Dated passport immigration stamp entry documenting when you immigrated into the U.S. c) Letter from the U.S. Citizenship and Immigration Services (USCIS) indicating entry into the U.S. d) A student visa form (I-20) or other valid U.S. passport visa stamp with expiration date (dates must be from entry date until age 26)
C. Signature and Certification Each person signing below certifies that all of the information reported is complete and correct. The student and one parent whose information was reported on the FAFSA must sign and date. WARNING: If you purposely give false or misleading information, you may be fined, be sentenced to jail, or both.
__________________________ Student Print Name
___________ Valencia ID#
__________________________ Student Signature
___________ Date
INTERNAL USE ONLY: Selective Service form would satisfy requirement: SELSER Return completed and signed forms to the Answer Center on your campus or mail to: Valencia College ■ Office of Financial Aid Services ■ 1800 South Kirkman Road ■ Orlando, FL 32811 Revised November 2015
