ࡱ> RTQY !bjbjGG .>-b-b  ***8b~\*g,+++++++$/.0| ,&&& ,!,(((&:+(&+((*h>+l:6&@++7,0g,.+a1 'a1 >+a1>+( T# , ,'g,&&&&a1 B : ACADEMIC COMMON MARKET APPLICATION FOR CERTIFICATION STATE OF ARKANSAS Name Social Security NumberPermanent Address Present Mailing Address Email Address Telephone Number How long have you resided in Arkansas? (years, months) U.S. Citizen (yes or no) Permanent Resident (yes or no) Submit a copy of your green card (front & back) Name of Institution You Plan to Attend Academic Term & Year You Will Enroll Student ID NumberDEGREE and PROGRAM of STUDY (*Attach the letter from the Office of Admissions that verifies your unconditional acceptance into an approved degree program.) Mode of Delivery of Program (Choose one: Traditional or online) PROOF of RESIDENCY: An individual must be a legal resident of the State of Arkansas for six continuous months prior to applying for ACM certification. An individual living in Arkansas solely for the purpose of attending an Arkansas college or university is not a legal resident of the state and cannot be certified for the Academic Common Market. A non-resident student must live in Arkansas for six continuous months following graduation from an Arkansas college or university to be eligible for participation in the Academic Common Market. I request certification as a legal resident of the State of Arkansas and hereby submit two or more of the following documents as evidence in support of this fact. (Photocopies are acceptable.) Proof of payment of current Arkansas property tax (for the previous year) Proof of full-time employment in Arkansas (for the past six months) Proof of current Arkansas drivers license (issued at least six months prior to submitting application) Proof that your spouse is a legal resident of Arkansas (for the past six months) If a dependent, provide evidence that parent/guardian is an Arkansas resident. (listed on your parent/guardian federal or state tax return for the previous year) I understand that this evidence will be used in reviewing the assertion that I am a legal resident of the state of Arkansas and will not necessarily result in a possible finding. I hereby certify that the statements made herein are true and accurate to the best of my knowledge. Applicants Signature ________________________________________________ Date__________________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (Please do not write in the space below) The applicant named above is hereby certified as a legal resident of the state of Arkansas. As such he/she is entitled to a waiver of out-of-state tuition in the program stated above, assuming acceptance for admission by the institution. Certifying Official ___________________________________________ Date __________________ ACADEMIC COMMON MARKET Certification Process State Of Arkansas Submit a copy of the letter from the institutions Office of Admissions that verifies unconditional acceptance into a degree program approved for the Academic Common Market (ACM), and the Application for Certification to: ACADEMIC COMMON MARKET Arkansas Department of Higher Education 423 Main Street, Suite 400 Little Rock, Arkansas 72201 Be sure to include copies of documentation to prove Arkansas residency. (An individual must be a legal resident of the State of Arkansas for six continuous months prior to applying for ACM certification. An individual living in Arkansas solely for the purpose of attending an Arkansas college or university is not a legal resident of the state and cannot be certified for the Academic Common Market. A non-resident student must live in Arkansas for six continuous months following graduation from an Arkansas college or university to be eligible for participation in the Academic Common Market.) The certification will be mailed to the ACM Coordinator at the institution listed on the application. Questions should be addressed to the Arkansas State Coordinator. Telephone 501.371.2060 Fax 501.682-6399 Email Alana.boles@adhe.edu ACADEMIC COMMON MARKET Through the Academic Common Market, a program coordinated by the Southern Regional Education Board (SREB), students in 16 southern states can enroll in selected programs at public institutions in other states and pay in-state tuition. (The degree program cannot be offered at a public Arkansas institution.) The Academic Common Market is not a distance learning program; students must attend classes at the college or university. The programs available to Arkansas residents through the Academic Common Market are listed below. For information on admission to any of these programs, contact the college or university directly. Once you are accepted into one of these programs and can provide the required documentation that proves you are a legal resident of Arkansas, contact the Arkansas Academic Common Market Coordinator to become eligible for the tuition reduction. (An individual living in Arkansas solely for the purpose of attending an Arkansas college or university is not a legal resident of the State and cannot be certified for the Academic Common Market.) The states participating in the Academic Common Market are Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. North Carolina, Florida and Texas participate only at the graduate level. Clemson University, Georgia State University, and The College of William and Mary (VA) participate only at the graduate level. James Madison University (VA), Mary Washington College (VA), The University of Virginia, The University of Texas at Austin, Virginia Commonwealth University, and the University of Maryland at College Park do not participate in the Academic Common Market. *The University of Alabama and The University of Georgia limit undergraduate participation to the junior and senior years. *Auburn University (AL) participates only at the undergraduate level and participation is limited to junior and senior students who meet certain requirements. Please contact The University of Alabama, The University of Georgia and Auburn University for more details. The number and types of programs available through the Academic Common Market change continually. A few programs are available via distance technology through the Academic Common Market/Electronic Campus (ACM/EC). 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