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InTenDeD lOAD Number of units in which you will probably enroll (check one):
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n 7 or more units n Less than 7 units
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nUMBeR OF hOURS yOU ARe PlAnnInG TO WORK, IF Any, WhIle ATTenDInG ThIS TeRM: __________
hIGh SChOOl lAST ATTenDeD
NAME OF HIGH SCHOOL
Years Attended: ________ – ________
COUNTY (IF CALIF.)
OFFICe USe Only – ST.Ty MT NM SP
ENTER APPROPRIATE CODE N = Did not graduate and no longer attend Y = Received diploma from U.S. high school G = Received GED C = Received Certificate of Proficiency F = Received foreign high school diploma H = Currently enrolled in high school
STATE OR COUNTRY (IF NOT CALIF.)
Year Graduated: ____________
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PRIOR COlleGe(S) OF ATTenDAnCe NAME OF COLLEGE STATE OR COUNTRY IF NOT CALIFORNIA YEARS ATTENDED COMPLETED UNITS/CREDITS
–
–
–
Highest degree earned, if any: n associate degree n bachelor degree or higher
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STATeMenT OF leGAl ReSIDenCe
(To be completed by all students who have not lived in California continuously for the last two years.)
ReSIDenCy To be considered a resident a student must have lived in California with the intent of becoming a permanent resident for at least one year prior to the first day of classes for the term in which he/she is enrolling. Exceptions may apply for active military personnel or students under 19 years of age. lIST The ADDReSS(eS) WheRe yOU hAVe lIVeD FOR The PAST TWO yeARS, BeGInnInG WITh yOUR CURRenT ADDReSS CITY STATE FROM: MONTH/DAY/YEAR TO: MONTH/DAY/YEAR
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IF YOU ARE UNDER 19 YEARS OF AGE, ANSWER THE QUESTIONS BELOW FOR YOUR PARENTS
1. Did you file California State Tax on total income last year? n Yes n No 2. In what state are you registered to vote? ___________________________ Last voted: State ____________________ Date ___________________ 3. Do you possess a valid California Driver’s License? n Yes n No If yes, date issued _________________________________ 4. Have you attended an out-of-state college or university in the last year as a resident of that state? n Yes n No 5. Have you petitioned for a divorce in another state in the last year? n Yes n No 6. Are you on active duty in the U.S. Armed Forces? n Yes n No Home of record on military records _______________________________ 7. Are you a spouse or dependent child of a person on active military duty? n Yes n No Students under 19 years of age must answer questions 1-7 above for their parent(s) as well as the following questions. Have you lived continuously for the past two years with one or both of your parents? n Yes n No If yes, check one: n Both Parents n Mother n Father If no, with whom have you lived? __________________________________________________________ Are they legal guardians? n Yes n No How long have your parent(s) or legal guardians lived in California? From _________________________ to _________________________
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MONTH/DAY/YEAR
MONTH/DAY/YEAR
TO Be COMPleTeD By All STUDenTS
I hereby swear under the possible penalty of perjury that the information submitted on this document is complete and accurate. I further agree that any information I am asked to update in the future will also be complete and accurate. DATE _____________________________ STUDENT SIGNATURE ______________________________________________________________________
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OhlOne COlleGe
SPRInG 2014