Citizenship Information. Fill in this section only if you selected "No" to "Are you a U.S. citizen?" U.S. Permanent Resident

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1 Citizenship Information Are you a U.S. citizen?* Yes No oceed to the Other Information section below. If No, complete the appropriate remainder of this section. Fill in this section only if you selected "No" to "Are you a U.S. citizen?" U.S. Permanent Resident Resident Alien number: Date issued: mm/dd/yyyy Also, if under 23 years of age, you must supply parent's Resident Alien number: Date issued: mm/dd/yyyy (Attach a copy of your Resident Alien registration card(s) to your signed application agreement statement.) Non-U.S. Citizen Country of citizenship: Country of birth: Type of visa: Expiration date: mm/dd/yyyy (Attach a photocopy of your visa to your signed application agreement statement.)

2 . Enrollment Information What will be your proposed major or field of study?* Undecided While at this college, do you intend to:* Earn an AA, AS, or AGS degree Earn a technical degree (AAS) Earn a certificate Take a few courses then transfer to another college Take a few courses for job or career reasons Attend for personal interest None of the above Optional Information Do you consider yourself to be economically disadvantaged? Do you consider yourself to be academically disadvantaged? Do you consider yourself a displaced homemaker?

3 Do you consider yourself a single parent? Is your primary language other than English? If yes, which language? Responses in this section are voluntary, will be kept confidential, will not be used in a discriminatory manner, and are intended to support actions designed to promote students' participation in the educational programs offered by the college.the information will not be used as a factor in acceptance to the college. Ja m ie, if yo u h av e a n y Educational Information Questions with an asterisk (*) are required. Other questions may also be required based on your answers. Did you receive a GED? If yes, date GED earned: Last High School Attended No High school:* AFTON HIGH SCHOOL City:* U.S. state/territory:* Oklahoma Zip code: Country: United States of America Int'l postal code:

4 Date from:* Graduation date (actual or planned):* to:* SASID: The SASID is a ten-digit Colorado high school identification number. Have you homeschooled? No If yes, are you still being homeschooled? Dates from: to: Contact institution for application instructions. College/University List the colleges you have attended below for which you would like a transfer evaluation. A transfer evaluation requires that you submit an official college transcript. If you are a new student and have no prior college, please leave this section blank. College/University 1 College/University: Click the 'Find' button to select the institution City: U.S. state/territory: Zip code: Country:

5 Int'l postal code: Date attended from: to: Degree: Date earned: Add Another College/University College/University 2 College/University: Click the 'Find' button to select the institution City: U.S. state/territory: Zip code: Country: Int'l postal code: Date attended from: to: Degree: Date earned: Add Another College/University College/University 3

6 College/University: Click the 'Find' button to select the institution City: U.S. state/territory: Zip code: Country: Int'l postal code: Date attended from: to: Degree: Date earned: Add Another College/University College/University 4 College/University: Click the 'Find' button to select the institution City: U.S. state/territory: Zip code: Country: Int'l postal code: Date attended from: to:

7 Degree: Date earned: Are you a first generation college student? Yes If no, which of your parents attended college? Tuition Classification Ja m ie, if yo u h av e a n y te ch ni ca l q u es ti o ns, Questions with an asterisk (*) are required. Other questions may also be required based on your answers. Are you claiming Colorado residency for in-state tuition classification?* Yes No If Yes, completion of all questions in this section is required. Failure to do so may result in your classification as an out-of-state student for tuition purposes. Information about Colorado residency requirements, including exceptions for military personnel and their dependents, can be viewed on each institution's Tuition Classification website. If applicable, please submit court order appointing legal guardianship. Length of connection to the state of Colorado can demonstrate your intention to make Colorado your long-term/permanent home. For the last 3 years, were you enrolled in a Colorado public or private high school AND did you or will you graduate before you enroll in college?

8 Did you earn a GED in Colorado AND have you resided in Colorado for the last 3 years? Parent or Guardian Information (if you are under 23) Parent/Guardian's dates of continuous physical presence in Colorado from: to: Parent/Guardian's dates of extended absences from Colorado* (more than two months in the past two years) from: to: *Explanation: Parent/Guardian's dates of employment in Colorado from: to: List last two years parent/guardian(s) have filed Colorado state income taxes: yyyy Have your parent/guardian(s) filed Colorado state income taxes as a partial year resident in the last three years?

9 Parent/Guardian's current driver's license number: (Do not include dashes) or Colorado ID: U.S. state/territory issued: Date issued: Parent/Guardian's previous driver's license: U.S. state/territory issued: Date issued: Parent/Guardian's vehicle license plate number: List two years of parent/guardian's Colorado motor vehicle registration: yyyy Parent/Guardian's date of Colorado voter registration:

10 Parent/Guardian's date of purchase or lease of Colorado residential property: Parent/Guardian's dates of military service from: to: For information about tuition classification exceptions for military personnel and their dependents, check the tuition classification information on the website for this institution. If your parents are separated or divorced, which one lives in Colorado? ^ Please submit a copy of the court order appointing legal guardianship. Be sure you have included the full name and Colorado address of at least one parent/legal guardian in the Contact Information section (Screen 5). Student Information Your dates of continuous physical presence in Colorado from: to: Your dates of extended absences from Colorado* (more than two months within the past two years) from: to: *Explanation:

11 Your dates of employment in Colorado from: to: List last two years you have filed Colorado state income taxes: yyyy Have you filed Colorado state income taxes as a partial year resident during the last three years? Your current driver's license number: (Do not include dashes) or Colorado ID: U.S. state/territory issued: Date issued: Your previous driver's license: U.S. state/territory issued:

12 Date issued: Your vehicle license plate number: List last two years of your Colorado motor vehicle registration: yyyy Your date of Colorado voter registration: Your date of purchase or lease of Colorado residential property: Your dates of attendance in Colorado high school(s) from: to: Your dates of military service from: to: For information about tuition classification exceptions for military personnel and their dependents,

13 check the tuition classification information on the website for this institution.

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