Residency Exemption Request

Student Name Student Name * First Last
JU Student ID# *
Jacksonville Mailing Address Jacksonville Mailing Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
JU Email Address *
Date of Birth Date of Birth * / MM / DD YYYY
Term Entering *
Year Entering *
Please select the exemption(s) you meet. If applicable, documentation may be uploaded below. *

Please select the exemption(s) you meet. If applicable, documentation may be uploaded below. Is OVER the age of 22 before the first day of classes of the term. Is legally married, as defined by the state of Florida. Please include a certified copy (not a photocopy) of your marriage license. Is a member of a branch of the armed services on active duty. Please include an authorized letter from the military verifying your active duty status. Is a transfer student who is at least three years removed from high school graduate date. Time spend in IB or dual enrollment do not count towards this three years. Resides with an immediate family member within 30-miles of Jacksonville University, located at 2800 University Blvd. N, Jacksonville FL 32211. An "immediate family member" is a parent, child, legal guardian, or sibling. I do not meet any of the exemptions.
Please include a certified copy (not a photocopy) of your marriage license. *

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Please include an authorized letter from the military verifying your active duty status. *

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Please list the year you graduated from high school. *
Whom do you live with in Duval County, Florida? *

Whom do you live with in Duval County, Florida? Parent(s). You will need to provide a copy of their Driver’s License showing a Duval County address, and a brief statement from them verifying the living arrangement. Legal guardian(s). You will need to provide a copy of their Driver’s License showing a Duval County address, a brief statement from them verifying the living arrangement, and documentation confirming legal guardianship. Sibling. You will need to provide a copy of their Driver’s License showing a Duval County address, 2 brief statements, one from a parent or legal guardian, and one from the sibling verifying the living arrangement. Child. You will need to provide a brief statement from your parent or legal guardian verifying the living arrangement and documentation confirming your parenthood.
Parent, legal guardian, or sibling's Driver's License *

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Brief Statement *

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Additional Documentation *

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Please explain. *
Relevant Documentation (Optional)

Attach Files
I understand that completion of this form is a request and does not guarantee exemption from the Jacksonville University residency requirement. The Residential Life Office will review all applications and communicate whether or not a residency exemption has been granted. This form is valid for one academic year and must be resubmitted and approved each academic year the student wishes to utilize the exemption. *

I understand that completion of this form is a request and does not guarantee exemption from the Jacksonville University residency requirement. The Residential Life Office will review all applications and communicate whether or not a residency exemption has been granted. This form is valid for one academic year and must be resubmitted and approved each academic year the student wishes to utilize the exemption. I understand.