Registrar: Application For Military Spouse/Dependent Tuition Rate

1Section A > 2Section B > 3Section C > 4Submission
Application For Military Spouse/Dependent Tuition Rate Form
Office of the University Registrar
Division of Student Engagement & Enrollment Services

1009 Rollins Hall ● Norfolk, VA 23529-0052 ● Telephone: (757) 683-4425 ● Fax: (757) 683-5357
Application For Military Spouse/Dependent Tuition Rate
For Semester *
For Year *
Student Name Student Name * First Middle Last
(First Name, Middle Name or Initital, Last Name)
University ID Number (if known):
Must be 8 characters. Currently Entered: 0 characters.
Date of Birth Date of Birth * / MM / DD YYYY
Email Address: *
Are you a Fry Scholarship recipient? *

Are you a Fry Scholarship recipient? Yes (fill out section A only) No
SECTION A – To be completed by Fry Scholarship recipient:

Documentation required:
1. Copy of VA Certificate of Eligibility
2. Proof of student’s Virginia residency
Upload File(s): *

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