Student Declaration of Independence Form

Student Declaration of Independence Form
Use this Student Declaration of Independence Form to confirm your independence status. Please provide accurate information regarding your living and financial situation. All responses will be reviewed for verification purposes.
Full Name
First NameLast Name
Student Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
What is your current living situation?
Other
Do you receive financial support from your parents or guardians?
Please summarize any documentation you can provide regarding your independence (if applicable).
Additional Explanation or Notes
Should be Empty: