Important

Don't guess - ask us! Choosing the wrong residency category can delay your enrollment.

Email: admissions@chipola.edu

Phone: 850-718-2211

Chipola Student ID:

Student Name:

Tell us about your Residency Status

Answer the following questions to help us determine your residency classification for tuition purposes. Your answers will determine which sections of this form you need to complete

Are you 24 years of age or older?

What year and term are you applying this residency for: 

What is the purpose of this submission?

What is your citizenship status?

U.S. Citizenship Proof

What type of document will you be providing to verify citizenship United States?

Permanent Resident Proof

Upload a copy of your current Permanent Resident Card. Accepted documents include:

• Permanent Resident Card — Green Card (Form I-551 or I-151)
• Foreign passport with I-551 stamp

Non-U.S. Student Proof

If you are here on a visa, what type of visa do you hold?

If you do not have one of the options from this list, go back and change your status to a permanent resident. 

Issue Date:

Resident Since

Accepted file types: .PDF, .JPG, .PNG, .DOCX 

Select the state where legal residence has been maintained for at least 12 consecutive months.

Complete this section for Non-Qualifying Residents

I do not qualify as a Florida, Alabama, or Georgia resident for tuition purposes for the term for which this application is submitted. I understand that should I qualify for a future term, it will be necessary for me to submit an updated Residency Declaration while providing prescribed, supporting documentation to substantiate as “reclassification” of my status. I understand being classified as a non-Florida resident will not exclude me from the possibility of receiving a waiver to cover part or all of the out-of-state fee as defined in s. 1009.26, Florida Statutes. Submission of an updated Residency Declaration must occur prior to the beginning of the term for which residency is sought. I do not have to complete any further portion of this form, with the exception of signing below.

Resident of:

By checking this box and typing my name below, I am electronically signing this form. 

PLEASE CONFIRM

Signature of Student

Please select date

Select the option that best describes your tax filing status. This determines whether your own residency or your parent's/guardian's residency will be used to establish Florida residency for tuition purposes.

Please select the type of student:

If you are unsure, please pick an option and see if you meet one of the requirements. 

Dependent Student

Before continuing, you will need the following information for your Claimant — the parent or legal guardian whose Florida residency qualifies you for in-state tuition:

• Parent/legal guardian's full legal name
• Parent/legal guardian's current Florida address
• Parent/legal guardian's contact information
• At least two documents verifying your parent/legal guardian's Florida legal residency
• Parent/legal guardian signature will be required on the Certification and Signature page

⚠️Please gather this information before proceeding to avoid being charged out-of-state tuition fees, which are currently nearly 3 times higher than the FL resident rate. 

Independent Student

⚠️Important: Failure to provide documentation will result in classification as a dependent student, and additional documentation will be required to avoid being charged out-of-state tuition fees, which are currently nearly 3 times higher than the FL resident rate. 

Upload Independent Student Verification Document

Upload a clear, legible copy of the supporting document that verifies your independent student status. Illegible or incomplete documents will cause delays in processing your residency classification. 

Qualifications by Exception

The following classifications are established under Florida Statute §1009.21(10). Select the option that best describes your qualifying situation. If you are qualifying based on the status of a parent, spouse, or employer, select the option that applies to that individual. 

This section is completed by the person claiming Florida residency on behalf of the student. If you are a dependent student, your parent or legal guardian is the claimant. 

Claimant's Relationship to Student:

*Legal documentation is required for legal guardian & other relative 

Claimant Information Only

This section is for your Claimant — the parent, step-parent, legal guardian, or relative whose Florida residency qualifies you for in-state tuition. Please enter their name, address, and contact information below, not your own.

Claimant - Name of Person (Parent/legal Guardian) Claiming Residency:

Claimant's Address:

Phone Number:

Proof of Legal Guardianship

Acceptable documents must show the student as a dependent or confirm your legal relationship. Submit one of the following:

• Most recent federal tax return listing the student as a dependent
• Court-issued guardianship or custody order

Accepted formats: .PDF, .DOC, .DOCX, .JPG, .JPEG, .PNG 

Dependent Student 

Documents submitted must verify the residency of your Claimant — the person whose Florida residency qualifies you for in-state tuition.

Who is my Claimant? Your claimant is typically your parent or legal guardian. If your parents are divorced or separated, either parent who is a Florida legal resident may serve as your claimant. If you live with an adult relative who has maintained Florida legal residence for at least 12 consecutive months, that relative may serve as your claimant.

You must provide a minimum of two documents that establish your claimant's Florida legal residency. At least one document must be selected from the Primary Documents list (Section A).

Important Note: A Florida Homestead Exemption is the sole sufficient document — no additional documentation is required if this option is selected.

Independent Student

You must provide at least two documents to establish Florida residency. At least one must be from the Primary Documents list. If you are a dependent student, these documents must verify your claimant's residency.

Note:A Florida homestead exemption is the sole sufficient document — no additional documentation is required if you select this option.

A. Primary Documents (select two options): 

Do you have a copy of two choices above to submit for verification?

B. Supporting Documents (select at least one additional to meet the two-document minimum):

Document 1 — Upload one document from the Primary Documents list (Section A) 

Document must be from Section A only.

Accepted formats: .PDF, .DOC, .DOCX, .JPG, .JPEG, .PNG

Document 2 — Upload your second verification document 

Document must be from Section A or B if answered No from previous question.

Accepted formats: .PDF, .DOC, .DOCX, .JPG, .JPEG, .PNG

Special Residency Classification

Select the classification that applies to you. You will be required to provide supporting documentation. If more than one classification applies, select all that apply.

Are you the qualifying individual, or are you a spouse or dependent child?

If you are claiming this exception through a family member's eligibility, select "Spouse or dependent child." You will need to upload proof of your relationship.

Upload Supporting Documentation for Your Special Residency Classification

Based on your selected exception, you are required to upload documentation that verifies your qualifying status. Documentation must clearly support the exception you selected on the previous page.

If you are qualifying based on the status of a parent, spouse, employer, or military branch, the documentation must reflect that individual's qualifying status.

Contact the Admissions and Records Office at admissions@chipola.edu if you are unsure what documents are required.

Accepted formats: .PDF, .DOC, .DOCX, .JPG, .JPEG, .PNG

Declaration Statement

Read the following statement carefully before signing. By submitting this form, you are certifying under penalty of Florida law that all information provided is true, accurate, and complete.

I, the undersigned, hereby declare that I have read the foregoing document and that the facts stated in it are true. I further affirm the authenticity of all information and documentation provided in support of this Residency Declaration.

I understand and acknowledge the following:

1. The claimant named on this form has established and maintained legal residence in Florida (or the qualifying state) for at least 12 consecutive months immediately prior to the first day of the term for which residency is being requested.
2. The residence claimed is a bona fide domicile — not a temporary address maintained solely for the purpose of enrollment at an institution of higher education.
3. I authorize Chipola College to review, examine, and verify any and all documents and records, including those accessible electronically, which may assist in support of this residency claim.
4. I understand that any false or misleading information provided on this form or in support of this form will subject me to penalties pursuant to Section 837.06, Florida Statutes, for making a false official statement.
5. I understand that submission of this form does not guarantee resident tuition classification. Residency is subject to review and approval by the Admissions and Records Office.
6. If residency is not verified prior to the first day of classes, out-of-state tuition rates will be assessed.

Student Signature:

Date:

Signature of claimant:

Date:

Communications on the status of residency will be emailed to your Chipola student email address (@my.chipola.edu). If residency is not verified, you will be charged out-of-state tuition costs, which are currently nearly three times higher than the Florida resident rate.

If you need to send in additional documents to verify residency, please email them to admissions@chipola.edu.