Though not legally required to pro-vide
your Social Security Number, we strongly
encourage you to do so. Your
Social Security Number is required if you
also need to supply a Social Secu-rity
Number if you apply as a degree-seeking
1.
2.
to the start of the semester
3.
months prior
1.
at a later date.
you will be assigned a Campus ID. After
we receive your application, we will mail
your Campus ID number, information on
how to activate your ac-count and
directions for establishing a password.
Once you have successfully set your
password, you will be able to access
campus computing resources, including
email.
The Accessibility
support, information and referral servic-es
to all UWM students with disabilities. To
receive services from
, you must
register with the Center and provide early
activity. For information or details, call the
Accessibility
Center at
414/229-6287 (Voice/TTY) or stop in
Mitchell Hall 112.
Call or visit us: (414) 229-4672
You’ll need to submit an Add/Drop Form in order to register
for your selected course. All audit courses require instructor
permission, so please complete and have your instructor
sign your Add/Drop form. This form can be picked up in
Mellencamp Hall, room 212, or found online at:
admissionforms.uwm.edu
*
UNIVERSITY OF WISCONSIN–MILWAUKEE
Office Use Only
q Res q Non Res
q Disabled
60+ and Disabled Auditor Application
Send completed application to Office of Undergraduate Admissions
P.O.Box749,Milwaukee,WI53201-0749•Fax:414-229-3788•Phone:414-229-4672•[email protected]
__________________________________________________________________________________________________________________________________________________________________________________________
Name: Use exact name as it should appear or as it appears on University records.
Last
First
Prior Name (if name changed since last enrolled at UW-Milwaukee)
Date of Birth: (mo/day/yr)
(required)
Middle
Are you a Wisconsin resident and do you claim exemption from
tuition according to Wisconsin Statutes 36.27(1)(b)? q Yes q No
Social Security #:
(optional)____________________________
UW-Milwaukee ID #:
(if known)____________________________
Attended
UW-Milwaukee
previously?
q Yes q No
Term applying for:
Year ______________
(check one)
q fall q spring q summer
Permanent Home Address: (primary residence)
Number and Street
City
State
Zip
From
(mo/day/yr)
To
(mo/day/yr)
Current
Other Address: Needed if at present address less than two years, or if you prefer we mail information to an
q mailing address alternate address (check one): q less than two years at present address
Number and Street
City
State
Zip
From
(mo/day/yr)
To
(mo/day/yr)
Last voted in Wisconsin: (mo/yr)
Citizenship: (check one)
q U.S. Citizen
q Permanent Resident (Immigrant)
q Refugee/Granted Political Asylum q International Applicant Visa type ____________
Driver’s license or state ID issued in: (give state)
Date of issue: (mo/yr)
Gender:
q female q male
Registered to vote in Wisconsin:
q Yes
q No
Do you file Wisconsin (not Federal) income tax returns as a resident?
q Yes; for which years?
q No; explain why not:
List employment and/or activities in the last two years. If you have been employed, list employer, city and state and
dates. If not employed, list volunteer and other activities, clubs or extended travel, with city and state and dates for each.
Be specific and cover entire time. Employment or activity
City/state
From (mo/yr)
E-mail address:_________________________________ Is this a good way to reach you?
To (mo/yr)
Current
q Yes
q No
Signature: To be valid, application must be signed and dated. I certify this information is true and complete.
Signature______________________________________
Rev. 6/12
Date___________________
Phone_________________
EXTRACT FROM SECTION 36.27(2)(e), WISCONSIN STATUTES OF 2005
RELATING TO EXEMPTION FROM NONRESIDENT TUITION AT
THE UNIVERSITY OF WISCONSIN–MILWAUKEE
36.27 Tuition.
(36.27(1)(b) (b) The board shall permit a person who is 60 years of age or older to audit a course without paying
an auditor’s fee if the person is a resident of this state, as determined under sub. (2) (e), space is available in the
course and the instructor approves.
Residency
(e) In determining bona fide residence at the time of the beginning of any semester or session and for the preceding 12 months the intent of the person to establish and maintain a permanent home in Wisconsin is determinative. In addition to representations by the student, intent may be demonstrated or disproved by factors including,
but not limited to, timely filing of a Wisconsin income tax return of a type that only full-year Wisconsin residents
may file, voter registration in Wisconsin, motor vehicle registration in Wisconsin, possession of a Wisconsin operator’s license, place of employment, self-support, involvement in community activities in Wisconsin, physical
presence in Wisconsin for at least 12 months preceding the beginning of the semester or session for which the
student registers, and, if the student is not a U.S. citizen, possession of a visa that permits indefinite residence in
the United States. Notwithstanding par. (a), a student who enters and remains in this state principally to obtain
an education is presumed to continue to reside outside this state and such presumption continues in effect until
rebutted by clear and convincing evidence of bona fide residence