Camp Community College – Domicile Exception Application

Domicile Exception Application

Complete all applicable sections across both pages of this form. Gather required supporting documents for your category (Dependent, Active Duty, or Veteran), sign the certification on page 2, and submit to the Financial Aid or Admissions Office on any campus.

* Indicates a required field.

This form is for active duty military members and their spouse/dependents, veterans and their spouse/dependents who may not qualify as being domiciled in Virginia for the purposes of in-state tuition. While this exception may result in a student being eligible for educational benefits reserved for those domiciled in Virginia, it is not a determination of domicile status.

Student Information

Student Details

Name

SIS ID

Address

City

State

Zip

Phone

VCCS Email

@email.vccs.edu

Semester for which you are seeking in-state tuition rate: Fall Spring Summer Year:

The Code of Virginia provides the following exceptions for active duty military personnel, their dependents, and veterans of U.S. military service.

Dependents — Code of Virginia §23.1-505

Spouse/Dependents of active duty military personnel (or activated/mobilized reservists or guard members) shall be considered domiciled in Virginia and afforded in-state tuition privileges if the military sponsor is:

Assigned to a permanent duty station or workplace in Virginia, or a contiguous state or the District of Columbia, and resides in Virginia;
Assigned unaccompanied orders and immediately prior to receiving such orders was assigned to a permanent duty station or workplace in Virginia, or a contiguous state or the District of Columbia, and resided in Virginia; or
Assigned unaccompanied orders with Virginia listed as the designated place to which to move.

The one-year residency condition normally required to establish Virginia domicile is not required for military dependents. The qualifying conditions must be in place at the time of acceptance to the college for dependents currently residing in Virginia or by the final add/drop date for dependents of service members newly transferred to Virginia.

Sponsor / Active Duty Member Name

Relationship to student: Parent Spouse Legal Guardian

Address of Residence (if same as student, indicate "same"):

Address

City

State

Zip

Permanent Duty Station (or location of immediately previous PDS)

Unaccompanied orders: No Yes

– Designated place to move:

Provide the following documents:

Current Military Orders (or previous military orders if currently unaccompanied)
Proof of living in Virginia (examples: utility bill, lease, deed, settlement statement, letter from landlord showing current Virginia Address, housing agreement from military housing office).
Student's DOD ID
Expire Date: Verified by:

Active Duty Military — Code of Virginia §23.1-505

Active duty military personnel (or activated/mobilized reservists or guard members) who reside in Virginia shall pay no more than the in-state tuition rate. Active duty member must provide the following documents:

Military ID Card
Expire Date: Verified by:
Proof of living in Virginia (examples: utility bill, lease, deed, settlement statement, letter from landlord showing current Virginia Address, housing agreement from military housing office).
Current Military Orders (to include activated or temporarily mobilized guard or reservist members).

Veterans of U.S. Military Service — Code of Virginia §23.1-505

Veterans discharged or released from military service under conditions other than dishonorable who reside in Virginia shall pay no more than the in-state tuition rate. Veteran must provide the following documents:

DD Form 214 (Member Copy #4), PHS Form 1867, or NOAA Form 56-16
Proof of Living in Virginia (examples: utility bill, lease, deed, settlement statement, letter from landlord showing current Virginia Address, housing agreement from military housing office).

Spouses and Dependents who live in Virginia (regardless of his or her formal state of residence), who are enrolled at the college and use educational benefits under Chapter 30, 33, or 35 of Title 38, United States Code.

Student must provide the following documents:

Proof of using Chapter 30, Chapter 33, or Chapter 35 each term
Proof of living in Virginia (student) (examples: utility bill, lease, deed, settlement statement, letter from landlord showing current Virginia Address, housing agreement from military housing office).

Student Certification

I hereby certify that the information given is true, complete, and accurate. I understand that if I knowingly provide erroneous information in an attempt to evade payment of out-of-state tuition and fees, I may be charged out-of-state tuition for each term attended and I may be subject to dismissal from the College.

Student Signature:

Date:

Submit completed form to the Financial Aid or Admissions Office on any campus.

For Office Use Only

In-State Exception Granted Out-of-State Remains Pending

Reason:

Date Entered into SIS

Domicile Officer / CMVE Staff Initials

Content Approved by the Dean of Student Services — 2 Pages Revised August 2022

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