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					    Instructions and Requirements for Petitioning Georgia Southern University
           for Classification as an In-State Student for Tuition Purposes

Georgia Southern University is required, under the guidelines established by the Board of Regents of
the University System of Georgia, to determine the residence classification of all applicants and
students of Georgia Southern University for fee payment purposes.

Students are responsible for notifying GSU of incorrect residence classifications and will be liable for
additional fees. Individuals who are classified non-resident by the University, but who claim to qualify
as legal residents, must file a “Petition for Georgia Residence Classification” form with GSU .
Resident status is not changed automatically, and the burden of proof rests with the student
to demonstrate that he or she qualifies as a legal resident under the regulation of the Board of
Regents of the University System of Georgia. To ensure timely completion of required processing
by GSU, a student or applicant requesting a change of residence for a specific term should file the
“Petition for Georgia Residence Classification” and all supporting documentation two weeks prior to
the published registration date for the term for which the change is requested. Resident status will
not be considered for a term after 60 calendar days from the first day of classes. Classification as a
legal resident for fee payment purposes will not be retroactive for prior terms.

Items to be included with Your Petition:
**BE SURE TO MAKE COPIES OF ALL DOCUMENTATION!!! COPIES WILL NOT
BE MADE FOR YOU IN THE OFFICE!!!**

1. A notarized statement from your employer(s) verifying any employment during the last 12 months.
Statement should indicate dates of employment and whether full or part time. This statement does
not have to be notarized if it is on company letterhead.

2. A copy of lease or deed showing your residence during the last 12 months. If this lease is not in
your name, please include a notarized statement from the person who is on the lease stating that you
do in fact live with him/her and how long you have resided with the person.

3. A copy of yours and/or your parent’s last Georgia Income Tax return or statement of intent to file
current year tax and Federal Income Tax return. **(If you intend to base your petition
on your parent’s tax information, please provide a copy of your birth
certificate.)
4. Copy of your last pay stub/receipt.

5. Photocopy of Driver’s License.

6. Photocopy of Automobile Tag Receipt.

7. Verification of voter registration in Georgia.

8. If a resident-alien, furnish a copy of your resident alien card (please furnish both sides).



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9. Any additional information you feel is relevant in proving that you should be classified as a Georgia
Resident for fee payment purposes.

NOTE: Students are expected to pay out-of-state fees if a decision has not been reached by the fee
payment deadline. This will prevent the cancellation of classes for non-payment. If you qualify for in-
state status, you will be reimbursed the difference in tuition for that term.

Further Information: You may consult your general catalog (current year’s at the Registrar’s Office
web address http://www.students.georgiasouthern.edu/registrar/) for further information regarding
residency.

New undergraduate and graduate students should submit their petition to:

             Rashonda Bostic
             Office of Admissions                      Tel: (912) 871-1282
             P.O. Box 8024                             Fax: (912) 871-1156
             Georgia Southern University
             Statesboro, GA 30460
             rbostic@georgiasouthern.edu

Currently enrolled undergraduate and graduate students should submit their petition to:

             Tifani L. Pool
             Office of the Registrar                   Tel: (912) 681-0283
             P.O. Box 8092                             Fax: (912) 681-5712
             Georgia Southern University
             Statesboro, GA 30460
             tlanding@georgiasouthern.edu




             Petition for Classification as an In-State Student for Tuition Purposes
                                   Georgia Southern University




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 Registrar’s Office Use Only--Please Do Not Write in This Space

 9Petition approved                                       9Denied            By______________________

 Effective Term ___________________                       Date ___________________________

 Additional Comments: ____________________________________________________________

 ______________________________________________________________________________


I. Personal Information

Legal Name ______________________________________________________________________
                 LAST                             FIRST                             MI


Eagle ID Number _____________________ Date of Birth _________________ Age ____________

Marital Status ________________ If Married, Spouse’s Name ______________________________

Local Address ____________________________________________________________________
                  STREET                                       CITY                 ST                    ZIP


Permanent Home Address __________________________________________________________
                                   STREET                             CITY                    ST                    ZIP


Local Phone Number ________________________ Email Address __________________________

Term Petitioning for: ____________________ Date Residence began: ________________________

Petitioning on Basis of: Parent/Guardian ________ Self________ Spouse________

State of Residence prior to moving to Georgia: __________________________________________

Reason for moving to Georgia: _______________________________________________________

II. Employment/Educational Information
Please list educational attendance for the past 12 consecutive months; please fill in gaps in
enrollment to show where you were when you were not in school:

From: ______ To: ______             ________________________________________________________
      month/yr          month/yr    Institution                                     City/St               State of Residency


From: ______ To: ______             _________________________________________________________
      month/yr          month/yr    Institution                                     City/St               State of Residency


First Term enrolled at GSU __________________________
Last Term enrolled at GSU __________________________
High School last attended ______________________________ From:______To: ________
                                                                               month/yr        month/yr




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Please list all employment for the past 12 consecutive months:

From: ______ To: ______          _________________________________________________________
        month/yr   month/yr      Employer                                    City/St          Full or Part time


From: ______ To: ______          _________________________________________________________
        month/yr   month/yr      Employer                                    City/St          Full or Part time


From: ______ To: ______          _________________________________________________________
        month/yr   month/yr      Employer                                    City/St          Full or Part time


From: ______ To: ______          _________________________________________________________
        month/yr   month/yr      Employer                                    City/St          Full or Part time


My absences from Georgia (other than for vacation or visitation of two weeks or less) after the date I
claim my permanent residence began and the purpose of the absences were:

________________________________________________________________________________
Dates                 Location              Reason


________________________________________________________________________________
Dates                 Location              Reason


________________________________________________________________________________
Dates                 Location              Reason


III. Financial Support
Distribution of financial contributions to your education (should total 100%):

Parents_______% Other relatives________% Gifts_________%              Savings_________%

Spouse_______% Employment__________%                     Summer Employment_________%

Financial aid_________% Trust Funds_______%              Other________%(specify)

If supported by a trust fund, state to which the trust fund pays income tax ______________________

IV. Parental/Family Information

Father’s name and address__________________________________________________________

Mother’s name and address_________________________________________________________

Spouse’s name and address_________________________________________________________




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If your parent(s) or spouse were a legal resident of Georgia, give addresses and dates of residence:

________________________________________________________________________________

________________________________________________________________________________

Name of court appointed legal guardian and address______________________________________

      Dates of Georgia residence for legal guardian___________________________

      Dates of appointment__________________

      Name of Court_______________________


List other relatives who reside permanently in Georgia and consider themselves Georgia residents
(including spouse):

________________________________________________________________________________

________________________________________________________________________________

V. Information on International Students

Do you have a permanent resident alien card?________
      If yes, what date was resident alien status received ________(attach a copy of both sides)

Country of citizenship_____________________Type of Visa held________________________
      Date received visa allowing permanent residence in the U.S._______________________

VI. Miscellaneous Information

Are you registered to vote? _______ If yes, where? ____________________________________
Date last voted: _____________________

Organizations and Activities in which you participate (social, business, community, etc):

________________________________________________________________________________

________________________________________________________________________________

Do you own/drive a car/truck in Georgia? _________ Where is this vehicle registered? ___________

Do you have a savings or checking account in Georgia? _________
If yes, where? ____________________________________________________________________




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In the space provided below and, if necessary, continue on an attachment to this petition, provide a
clear and complete statement covering the following items and any other facts and circumstances
that, in your opinion, establish your legal residence in Georgia:
        a.     Purpose in coming to or remaining in Georgia
        b.     When you decided to become a permanent resident of Georgia
        c.     Immediate and long-range plans
        d.     Whether you expect to move out of state after completing your studies at Georgia
               Southern University or remain in Georgia indefinitely.
________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

The undersigned hereby affirms the authenticity of the information provided in this petition. I
understand that any false or misleading information on this petition will jeopardize my admission or
right to continue at GSU. I also authorize GSU to review or examine any and all documents and
records, including my confidential loan forms and related information, which may assist in clarifying
my residency status.

________________________________
Student’s Signature

(06/07/06)




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