Alabama A&M University - Alabama Residency Certification Form
Term: Fall 2019 thru Summer 2020
Student Type *
Student ID *
Your answer
Last Name *
Your answer
First Name *
Your answer
All students claiming to be Alabama residents and are recipients of instate tuition rates, must confirm to the following by providing an electronic signature and initials below:
1. I Live within the state of Alabama: *
Initials
Your answer
2. My street address is: *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
3. I intend to live in Alabama indefinitely: *
Initials
Your answer
4. I have more substantial connections with the state of Alabama than any other state: *
Initials
Your answer
I certify that the statements on this form are correct and completed by my individual initials and electronic signature below. *
Signature (Type Full Name)
Your answer
Today's Date *
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