Selective Service Affidavit (FA)

Office of Student Fiscal Affairs

SELECTIVE SERVICE AFFIDAVIT

Notice: You will not receive Title IV Financial Aid unless you complete this statement and, if required, give proof to the MSM Student Fiscal Affairs Office that you are registered with Selective Service.

I certify that I am not required to register with Selective Service (please write your name in box below). *

Please select one from the following list: *

I am female.

I am in the Armed Services on Active Duty

I have not reached my 18th birthday.

I was born before 1960.

I am a permanent resident of the Trust Territory of the Pacific Islands on the North Mariana Islands.

I am citizen of the Marshall Islands, the Federated States of Micronesia, the Republic of Palau.

I certify that I am registered with Selective Service.

Signature *

Today's Date * +

Social Security Number *

E-mail *