Registrar: Application for In-State Tuition

1SECTION A: APPLICANT > 2SECTION B: STUDENT DEPENDENCY > 3SECTION C: RESIDENCY > 4SECTION D: ALTERNATE IN-STATE > 5SECTION E: SIGNATURE
Application for In-state Tuition
Office of the University Registrar
Division of Academic Affairs

1009 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-4425 ● Fax: (757) 683-5357
Application for In-State Tuition

Due by 11:59 PM on the first day of classes of the term for which you are applying
• This form must be completed if you are claiming entitlement to in-state tuition benefits pursuant to §23.1-500-510 of the Code of Virginia.
• Supporting documents and additional information may be requested.
• All questions must be answered. Incomplete/unsigned applications will experience delays in processing.
SECTION A: APPLICANT (the student)
For Semester *

For Semester Fall Spring Summer
For Year *
Student Name Student Name * First Middle Last
(First Name, Middle Name or Initital, Last Name)
Preferred First Name
Maximum of 10 characters allowed. Currently Entered: 0 characters.
Date of Birth Date of Birth * / MM / DD YYYY
University ID Number (8-digit number starting with 00 or 01)
Must be 8 characters. Currently Entered: 0 characters.
Social Security Number:
Must be between 9 and 11 characters. Currently Entered: 0 characters.
(optional—for Federal reporting purposes)
ODU Email Address
(other email addresses are acceptable if you do not have an active ODU file): *
Daytime Phone: Daytime Phone: * - ### - ### ####
Permanent Address Permanent Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
From: From: * / MM / DD YYYY
To: To: * / MM / DD YYYY
PREVIOUS ADDRESS (required if you have lived at your permanent address less than two years): PREVIOUS ADDRESS (required if you have lived at your permanent address less than two years):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
If you have lived at your current address for 2 or more years, you do not need to fill out previous address
From: From: / MM / DD YYYY
To: To: / MM / DD YYYY
Are you a U.S. Citizen, U.S. Dual Citizen, or U.S. Permanent Resident? *

Are you a U.S. Citizen, U.S. Dual Citizen, or U.S. Permanent Resident? Yes No No, but I have applied for U.S. Permanent Residency
USCIS Document(s): (eg. I-94; I-551; I-766; I-797; etc.) *

Attach Files
-- Do you hold a B, F, J, M, or Q Visa? *

-- Do you hold a B, F, J, M, or Q Visa? Yes - Stop Here. You are not eligible for the Virginia In-State Benefit. No
-- Do you hold any United States Visa? *

-- Do you hold any United States Visa? Yes No
-- Visa Type (eg. H-1B; NATO6; R-1; U-2; etc.) *
Must be between 2 and 20 characters. Currently Entered: 0 characters.
-- Visa Expiration Date -- Visa Expiration Date * / MM / DD YYYY

Registrar: Application for In-State Tuition

SECTION A: APPLICANT (the student)