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 adm@cochise.edu. Complete all sections of the application form. You will receive an email confirmation of your application within 5 business days. Required entries are indicated with *.

Step 1 of 4

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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:*
First Middle Last
Previous Name (Maiden Name, etc.)
First Last
Cochise College ID# (if returning student)
Note: You will be assigned a Cochise College ID Number.
Social Security #*
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*
Please enter two-letter US State abbreviation (i.e. - AZ, MI, TX). For international addresses, please provide full description for the State/Providence/Region.

P.O. Box or Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone - Used for Emergency Notification System*
(###) ###-####
In addition to Emergency messages I would like to receive other college information.*
Yes
No
Primary Telephone, if different from cell phone number.
(###) ###-####
Email Address*
Enter Email Confirm Email
In Case of Emergency - Name
Emergency Phone
(###) ###-####
3 - ENROLLMENT INFORMATION
Semester you plan to enter Cochise College:*
Student Type
4 - BIOGRAPHICAL INFORMATION
Gender
Date of Birth*

MM/DD/YYYY
Ethnicity/Race Information
**Please answer both questions (requested for statistical purposes)
Are you Hispanic or Latino/Spanish origin?
What is your race? (choose one or more)
White
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native

5 - CITIZENSHIP STATUS
Students need to declare their citizenship or lawful immigration status and present designated documents for Prop 300. (List of Acceptable Documents PDF - link opens new window).
Citizenship
If other, specify country
Type of Visa
If other, specify visa type
6 - RESIDENCY INFORMATION
To be eligible for in-state tuition, students must:
- Provide Prop 300 indicating legal status in the United States
AND
- Have lived in Arizona for more than a year or

- Have a parent who has lived in Arizona for a year or more (if a dependent) or

- Is transferred to Arizona by employer or is stationed as military, border patrol, etc. or

- An honorably discharged veteran with a DD Form 214 residing in Arizona

Documents can be scanned and emailed to adm@cochise.edu or submitted in person at the closest campus or center near you, or to the Admissions Office at: Cochise College, Admissions, 901 North Colombo Ave., Sierra Vista, AZ 85635-2317.

Failure to answer any question or submit documentation will result in classification as a non-resident for tuition purposes. Contact the Admissions & Registration Office at 1-800-593-9567 if you have any questions about residency requirements.
When did your current residency in Arizona begin?

MM/DD/YYYY
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 within the last year?
If yes, name of employer
Are you a Veteran?
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

Military/Veteran Status
Arizona Unit Address / Installation
(Verification Required)
Active Duty Separation Date

MM/DD/YYYY
9 - COCHISE COLLEGE EDUCATION GOAL

Cochise College Education Goal
10 - HOW DID YOU HEAR ABOUT COCHISE

How did you hear about Cochise College?
If other, specify

11 - PREVIOUS SCHOOL INFORMATION

Previous School Information
Grade
Graduation Date
MM/YYYY
Expected Graduation Date
MM/YYYY
Name of High School
Online High School?
Name of Middle School (if currently attending)
City / State (Province)
City State

Student Accountability Information System (SAIS) Number
Your SAIS Number is the student ID number assigned to you by your Arizona school district or charter school in the year 2000 or later.
Transfer to Cochise Page (link opens new window)
To have transfer work evaluated, official transcripts must be requested from each institution and sent directly to Cochise College.

12 - DEGREES AND CERTIFICATES

Lifelong learning is the "ongoing, voluntary, and self-motivated" pursuit of knowledge for either personal or professional reasons.
Do you consider yourself a Lifelong Learner and do not need to be a degree seeking student (not Financial Aid eligible)?
Yes
No
I consider myself a Lifelong Learner and am not seeking a degree.
Which Area of Study are you pursuing?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Which Degree or Certificate?
Do you need to discuss your declared major with an advisor before the start of registration?
13 - INFORMATION RELEASE
Do you give permission for the college to release directory information (Name, Major, Attendance Dates, Enrollment Status, Degrees Received, and most recent attended institution) as per the Family Education Rights and Privacy Act of 1974?
14 - 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.
Signature (Enter Full Name)*
Date*

MM/DD/YYYY
Disability Services: Cochise College values inclusive learning environments and strives to make all aspects of the College accessible to our students. If you have a disability and believe you need an accommodation to improve access to learning and campus services, you may begin the Welcome Process and review the Disability Student Guide at the disabilities services page

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 520-515-3647 or 520-417-4050 or go to Student Complaint Form website (link opens new window).
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Comments
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This application must be completed for admission or re-entry to Cochise College.

Step 1 of 4

1 - STUDENT NAME / IDENTIFICATION

2 - CONTACT INFORMATION

3 - ENROLLMENT INFORMATION

4 - BIOGRAPHICAL INFORMATION

5 - CITIZENSHIP STATUS

6 - RESIDENCY INFORMATION

7 - FAMILY EDUCATION

8 - MILITARY / VETERAN STATUS

9 - COCHISE COLLEGE EDUCATION GOAL

10 - HOW DID YOU HEAR ABOUT COCHISE

11 - PREVIOUS SCHOOL INFORMATION

12 - DEGREES AND CERTIFICATES

13 - INFORMATION RELEASE

14 - VERIFICATION