Application for Admission to Cochise College

This application must be completed for admission or re-entry to Cochise College.

If you have questions about the application and its contents, please contact the Admissions Office (Sierra Vista Campus) at (800) 593-9567 or (520) 515-5336/5412. You may also email questions to admissions@cochise.edu. Complete all sections of the application form. When you are done, submit the form by clicking the Submit button. You will receive email confirmation of your application within 5 business days. Required entries are indicated with • Bold Headings •.

 1   Student Name / Identification
Information you provide is required and confidential and is used to comply with federal reporting requirements and has no effect on your enrollment status.
Complete Legal Name: • Last •   A value is required.
• First •   A value is required.
Middle  
Previous Name (Maiden Name, etc.)  
Cochise College ID #  
• Social Security # •   A value is required. - A value is required. - A value is required.

Note: You will be assigned a Cochise College ID Number. Disclosure of your social security number is requested and will aid in matching your current and future records with any past records, ensuring that you will receive full credit for all academic work. Your social security number is necessary for reporting education tax credit information to the federal government, for using federal financial aid, and for verification of student status under Arizona Proposition 300.

 2   Contact Information
• P.O. Box or Mailing Address •   A value is required.
• City •   A value is required.
• State •   A value is required.
• ZIP •   A value is required.
Telephone   ( ) -
Email Address  
In Case of Emergency: Name  
Phone   ( ) -
 3   Enrollment Information
Semester you plan to enter Cochise College   Year:
   




Student Type  


 4  Biographical Information
Gender  
Date of Birth   / /
(MM / DD / YYYY)
Ethnicity/Race Information
(please answer both questions)

Are you Hispanic or Latino/Spanish origin?
(Choose only one)
 

(requested for statistical purposes)


What is your race?
(Choose one or more)
 



 5 Citizenship Status

Students need to declare their citizenship or lawful immigration status and present designated documents (Click here for List of Acceptable Documents).

Documents can be faxed to 520-515-5452 or, scanned/emailed to admissions@cochise.edu or mailed or submitted in person to the Admissions Office at: Cochise College, Admissions Office, 901 North Colombo Ave., Sierra Vista, AZ 85635-2317.

Citizenship  

        If Other, Specify Country:
        Note: documentation required
Type of Visa
(If Not US Citizen)
 





        If Other, Specify:
 6  Residency Information
Note: Failure to answer any question may result in classification as a non-resident for tuition purposes. Contact the Admissions Office at (520) 515-5336/5412 or toll free 1-800-593-9567 if you have any questions about residency requirements.
When did your current residency in Arizona begin?  
Month/Day/Year
What are your sources of income?  


If spouse, are they an Arizona resident?



If parent or guardian, their address:
In which state will you file taxes this year?  
Did you file taxes in Arizona last year?  
Are you a member or family member of Homeland Security stationed in Arizona?  
Are you a full-time employee of an Arizona school district as a teacher or teacher's aide?  
Did your employer require that you, your spouse, or parent be transferred to Arizona?  

If yes, name of employer
Are you registered to vote in Arizona?  
Do you have an Arizona driver's license
or identification card?
 
Are you a member of an American Indian tribe whose reservation lies wholly, or in part, in Arizona?  
Note: Change in residency status from out-of-state must be initiated by you. Cochise College will not automatically adjust your status.
 7  Family Education
Are you a first-generation college student?
(neither parent attended college)
 
 8  Military / Veteran Status
   


-- ETS Date:


*Arizona Unit Address / Installation (Verification Required)
 9  Cochise College Education Goal
   






 10  How Did You Hear About Cochise College?
   

Please choose only one:













 11  Additional Information
Information you provide is required and confidential and is used to comply with federal reporting requirements and has no effect on your enrollment status.

This information is captured to determine if you may be eligible for services provided by the Carl Perkins Grant and for grant reporting purposes. Please check all that apply.
 12  Previous School Information
Check your status on the right and fill in the appropriate date, if applicable:  

: Month Year

: Grade
            Expected Graduation: Month Year

: Grade
            Expected Graduation: Month Year

: Month Year

certificate

School Information    
Name of High School  
Name of Middle School (if currently attending)  
City / State (Province)   /
College Information   To have transfer work evaluated, official transcripts must be requested from each institution and sent directly to Cochise College.
 13  Degrees and Certificates
Please select a degree or certificate from one of the lists below. Note: You may choose only one degree or certificate.
AA Degrees - For University Transfer  
AAEE Degrees - For University Transfer  
AS Degrees - For University Transfer  
ABUS Degrees - For University Transfer  
AGS Degrees - For University Transfer  
AAS Degrees - Two-Year Training for Employment  
Certificate Programs - Short-Term Training For Employment  
Other  
Students receiving veterans' benefits and financial aid cannot use this category.
     
   
 14  Information Release
Do you give permission for the college to release directory information relative to your enrollment (as per the Family Education Rights and Privacy Act of 1974)?
   

 

 15  Verification
I certify that the information given is complete to the best of my knowledge. I understand that submission of false information is grounds for denial of admission or immediate suspension if enrolled. If accepted as a student at Cochise College, I agree to abide by the rules and regulations of the college regarding conduct and other obligations. By entering my name and date below and then clicking the Submit button I verify the above to be true.
• Name •   A value is required.
• Date •   A value is required.

Disability Services: If you have a disability and require auxiliary aids, services, or other accommodations as a student at Cochise College, please contact the Disability Services Office at (520) 515-5337 or (520) 417-4023.

Notice of Non-discrimination: Cochise College does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability.  For additional information or to register a complaint, please contact the Dean of Student Services at 520-515-5329 or 520-417-4050 or go to www.cochise.edu .

Tuition Waivers

Arizona-Sonoran Agreement. Tuition waivers are available to students from Sonora through an agreement between the Arizona-Mexico Commission. For more information, visit www.iesa.gob.mx or contact the Cochise College International Student Office (520) 417-4038 or (520) 417-4042.

Golden Apache Tuition Waiver. Golden Apache fee waiver available for students 60 years of age or older. See Admissions Office for criteria.

New Mexico Tuition Waiver. New Mexico Tuition Waiver(NMTW) availble for New Mexico residents on a limited basis. See Admissions Office for criteria.

Western Undergraduate Exchange Tuition Waiver. Western Undergraduate Exchange (WUE) Program Tuition waiver available for students who live in one of the following states: Alaska, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming.

WWW.FAFSA.ED.GOV

Apply for financial aid early! You must complete and submit a Free Application for Federal Student Aid (FAFSA) to apply for federal student aid for college. The quickest way to apply is online using FAFSA on the web at www.fafsa.ed.gov.

The Financial Aid Office uses information from the FAFSA to determine if you are eligible to recieve federal student aid from grants, loans, and work-study programs. So be sure to fill out a FAFSA even if you think you won't qualify.

The Cochise College school code is 001072.

Also, find scholarship information at the college website: www.cochise.edu.

If you do not see a confirmation page after clicking the submit below,
be sure to check at the top of this page. You may have forgotten to fill in a box.

   


Cochise College - Cochise County, Arizona • All rights reserved 2005 - 2013


Last Updated On: 8/15/13