Florida International University
Please Note: This is not an application for Admission to a degree program at the University. Students desiring admission to a degree program must fill out an Admission Application with the Office of Admissions.
Note: If your address has changed since your last attendance at FIU, please fill out a Change of Address Form
Important: Have you ever received a grade from FIU? Yes __ No __
Non-degree seeking students have an affiliated or unaffiliated status. Affiliated non-degree seeking students must be approved by the appropriate School or College and must meet its specific requirements. Unaffiliated non-degree seeking students are limited to one semester courses at FIU.
If a non-degree seeking student changes to a degree-seeking status, only 15 credit hours taken as an undergraduate non-degree seeking student will apply toward the graduation requirements at FIU; or 12 credit hours as a graduate non-degree seeking student.
international students holding an F-1 visa cannot register as non-degree seeking students.
Social Security Number (SSN):|__|__|__| - |__|__| - |__|__|__| Term:____________________
Name: (Print, one character per block. Leave one block between names)
Telephone Number: Area Code:_______ Number:______________
Nation of Citzenship:________________ Place of Birth: ____________ Birthdate:________________
Sex: Male ___ Female ___
Race: (required by U.S. Department of HEW under Title VI of the Civil Rights Act)
(A) - Asian or Pacific Islander ____ (B) - Black (not of Hispanic origin) ___ (H) - Hispanic: __
Institution where most coursework or highest degree was granted:________________________________
Dates Attended: ________________ Highest degree earned: ____________ Date received: ___________
Have you ever been found by any school authorities or by any court to have disrupted or interfered with the orderly conduct, processes, functions, or programs of any other educational institution? Yes:__ No: __
If ‘yes’, please give details: _____________________________________________________________
Are you currently charged or have you been convicted or found guilty (even if adjudication withheld) of violating any federal or state law or municipal ordinance other than minor offenses involving a fine of $500.00 or less? Yes: __ No: __
If ‘Yes’’please give date, name of court, nature of offense, and penalty imposed, if any:__________________
Resident Alien Students: Alien Card number:____________________ Date Issued:_______________
INFORMATION FOR RESIDENCY CLASSIFICATION
A Florida “resident for tuition purposes” is a person who has, or a dependent person whose parent of legal guardian has, established and maintained legal residence in Florida for at least twelve months. Residence in Florida must be as a bonafide domicile rather than for the purpose of maintaining a residence incident to enrollment at an institution of higher education To qualify as a Florida resident for tuition purposes you must be a U.S. citizen, permanent resident alien, or legal alien granted indefinite stay by the Immigration and Naturalization Service. Other persons not meeting the twelve-month legal residence requirement may be classified as Florida residents for tuition purposes only if they fall within one of the limited special categories authorized by the Florida Legislature and Board of Regents. All other persons are ineligible for classification as a Florida “resident for tuition purposes”. Living in or attending school in Florida will not, in itself, establish legal residence. Students who depend on out-of-state parents for support are presumed to be legal residents of the same state as their parents.
I understand that I do not qualify as a Florida resident for tuition purposes for the term for which this application is submitted and that if I should qualify for some future term it will be necessary for me to file the required documentation prior to the beginning of the term in order to be considered for Florida residency classification.
Signature in ink:_______________________________ Date______________________
- Person claiming residency should complete this section in full.
1. Name of student: _________________________________ 2: Student Social Security___/___/___
3. Name of person claiming Florida residency____________________________
4. Claimants relationship to student______________________________
5. Claimant’s permanent legal address:_________________________________________________
6. Claimant’s Telephone Number: (____)_____________________
7. Date claimant began establishing legal Florida residence and domicile:____/____/____
8. Claimants voter registration: State:________ Number_________County________ Issue date___/___/___
9. Claimants driver license State:________ Number_________County________ Issue date___/___/___
10. Claimants vehicle registration State:________ Tag Number___________________ Issue date___/___/___
11. Non-U.S. Citizen only. Resident Alien Number:_____________________________Issue date___/___/___
I do hereby swear or 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 a false statement in this affidavit will subject me to penalties for making a false statement pursuant to 837.06 Florida Statutes and to BOR Rule 6C-6.001(6), F.A.C.