Residency Reclassification Request Form

The deadline to submit your residency reclassification request and documentation is always the eleventh class day for Fall and Spring, and the fifth class day for Summer. Requests received after the deadline may be considered for the next term.

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University of Arkansas Board of Trustees Policy

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The last day for residency reclassification for the Fall 2024 semester is 3 September 2024.

First Name

Middle Name

Last Name

UA Little Rock Student ID

Birthdate

Age:

Email Address

Phone number

Place of birth

What type of student are you?

When are you requesting reclassification?

Permanent Home Address

Country

Street

City

Region

Postal Code

How long have you resided continuously at this address?

Where did you live before residing at this address?

Are you a US citizen or permanent resident? - If you are on a temporary or student visa, you will not qualify for in-state tuition and fees.

If not a US citizen, what type of visa do you have?

Date Visa obtained

Are you a UA system employee or a spouse/minor dependent(under 18) of a UA system employee?

No

Yes

Please include a letter form HR showing proof of employment as a benefits eligible employee and if you are a spouse/dependent proof of relationship to employee.

Are you a member of the US military (active/guard/reserve) or separated under honorable conditions?

No

Yes

Please include a copy of one of the following as proof of military service

DD214(member copy 4) showing Honorable Discharge or Under Honorable Conditions
front of current military ID
most recent military orders assigning you to current duty station
copy of Service Verification Letter (available online at www.va.gov/records/download-va-letters
DD215 (with corrected discharge status) showing Honorable Discharge or Under Honorable Conditions
NGB-22
DD256/257

Are you a spouse/dependent of a US veteran and will be using military benefits?

No

Yes

Please include a copy of the veterans proof of service and proof that you are their spouse/dependent.

Examples of proof of service:

DD214(member copy 4) showing Honorable Discharge or Under Honorable Conditions
front of current military ID
most recent military orders assigning you to current duty station
copy of Service Verification Letter (available online at www.va.gov/records/download-va-letters
DD215 (with corrected discharge status) showing Honorable Discharge or Under Honorable Conditions
NGB-22
DD256/257

Are you a Native American belonging to one of the following - Caddo, Cherokee, Chickasaw, Choctaw, Creek, Delaware, Kickapoo, Osage, Quapaw, Shawnee, Tunica, and Peoria tribes?

No

Yes

Please include proof that your name is on the rolls in tribal headquarters.

Did you relocate to Arkansas for employment or are a spouse/dependent of someone that relocated to Arkansas for employment?

Please include a letter from employer showing date of hire and location of employment. If spouse/dependent, also include proof of relationship.

Marital Information

Marital Status

Single

Married

Divorced

Other

If other - please specify

Spouse's name

Date and Place of Marriage

Spouse's occupation

Is Spouse and Arkansas resident?

Financial Support
Please list percentage of total support from each source

Parents/Guardians

Investment Income

Employment

Other (please specify)

How will your sources of income change while attending UA Little Rock?

Parent/Guardian information
Supply this information if you are unmarried and and under the age of 23

Father's First Name

Father's Last Name

Father's Address

Country

Street

City

Region

Postal Code

Mother's First Name

Mother's Last Name

Mother's Address

Country

Street

City

Region

Postal Code

If parents' addresses are different, please explain.

Supporting Documentation
Upload the necessary supporting documentation before submitting this form. Examples of appropriate documentation are listed in the instructions.

Upload supporting documentation (jpg, gif, png, pdf, tiff, doc, docx)

Do you have an additional document to attach?

Please upload additional supporting document

Do you have an additional document to attach?

Please upload additional supporting document

Do you have an additional document to attach?

Please upload additional supporting document

Do you have an additional document to attach?

Please upload additional supporting document

By submitting this form, I affirm that all information supplied is complete and accurate. Any misrepresentation of facts could be just cause for dismissal from the university.

University of Arkansas at Little Rock

Residency Reclassification Request Form