MILITARY
VERIFICATION
FORM

Active duty military and members of the Texas Reserves or Texas National Guard, as well as their spouses and/or dependent children, stationed in Texas can qualify for in-state tuition and fees provided this form is completed and signed by the service member's Commander, Personnel Officer, or designated representative.
THIS FORM MUST BE SUBMITTED ONCE PER ACADEMIC YEAR
PLEASE CHECK ONE: Active Duty Military Dependent Reservist
Semester:
Fall
Fall Flex II
Spring
Spring Flex II
Summer I
Summer II
 Year:
SECTION I: SPONSOR INFORMATION
THIS SECTION MUST BE COMPLETED
This verification certifies that the following individual is currently assigned to duty in Texas, and the same will be in effect at the time of enrollment.
NAME : SSN:
HOME OF RECORD: STATE OF LEGAL RESIDENCE:
BASE/POST/UNIT : EXPIRATION DATE:
SECTION II: DEPENDENT INFORMATION
THIS SECTION MUST BE COMPLETED IF THE MILITARY DEPENDENT IS THE STUDENT
This verification certifies that the following individual is the dependent of the above named military member.
NAME: SSN
SECTION III: SIGNAURE OF AUTHORIZED PERSONNEL
THIS FORM IS NOT VALID WITHOUT THE SIGNATURE NOTED BELOW
The above information is correct according to military records.

______________________________________

______________________________________
SIGNATURE
INSTALLATION

______________________________________

______________________________________
TITLE
DATE
FOR OFFICE USE ONLY

Residency Code: ___________
Verification Code: ___________
Term:___________
State:___________
Verified by _____________
 
1300 San Pedro San Antonio, Texas 78212-4299
A College of the Alamo Community College District
Date last updated 9/21/06