Cochise College Admissions Application 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 email@example.com. 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 25% 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Cell Phone - Used for Emergency Notification System*(###) ###-####In addition to Emergency messages I would like to receive other college information.*YesNoPrimary Telephone, if different from cell phone number.(###) ###-####Email Address* Enter Email Confirm Email In Case of Emergency - NameEmergency Phone(###) ###-#### 3 - ENROLLMENT INFORMATIONSemester you plan to enter Cochise College:*Spring 2022Summer 2022Fall 2022Student TypeArmy IgnitEDHigh School / Middle School StudentFirst-time College Student (after High School)Transfer from Another College or University (after High School)Re-Admit (previously attended Cochise College)Adult Ed (attending the Adult Ed GED/ESL)4 - BIOGRAPHICAL INFORMATIONGenderMaleFemaleDate of Birth* MM/DD/YYYY Ethnicity/Race Information **Please answer both questions (requested for statistical purposes)Are you Hispanic or Latino/Spanish origin?Hispanic or Latino / Spanish OriginNot Hispanic or Latino / Spanish OriginWhat 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 STATUSStudents 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). CitizenshipUnited StatesOtherIf other, specify countryType of VisaInternational Student (F-1)Border CommuterPermanent ResidentResident Alien"Dreamer", Deferred Action Child Arrival (DACA)Other Type of VisaIf other, specify visa type6 - RESIDENCY INFORMATIONTo 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 firstname.lastname@example.org 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/YYYYWhat are your sources of income?Self-Supporting (self/spouse)Parent or guardianIf spouse, are they an Arizona resident?YesNoIf parent or guardian, their addressIn which state will you file taxes this year?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificDid you file taxes in Arizona last year?YesNoAre you a member or family member of Homeland Security stationed in Arizona?YesNoAre you a full-time employee of an Arizona school district as a teacher or teacher's aide?YesNoDid your employer require that you, your spouse, or parent be transferred to Arizona within the last year?Yes (Document Required)NoIf yes, name of employerAre you a Veteran?YesNoAre you registered to vote in Arizona?YesNoDo you have an Arizona driver's license or identification card?YesNoAre you a member of an American Indian tribe whose reservation lies wholly, or in part, in Arizona?Yes (Document Required)NoNote: 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)YesNo8 - MILITARY / VETERAN STATUS Military/Veteran StatusNon-MilitaryActive DutyReservistVeteranVeteran DependentMilitary DependentNational GuardArizona Unit Address / Installation(Verification Required)Active Duty Separation Date MM/DD/YYYY9 - COCHISE COLLEGE EDUCATION GOAL Cochise College Education GoalPI - Personal InterestTR - Transfer to a Four-year SchoolWK - Improve Work SkillsCR - Prepare for a New CareerCP - Complete a Certificate ProgramAD - Complete an Associate's DegreeCT - Complete associate's degree and transferES - Enrolled in other college/univ., supplementing coursework10 - HOW DID YOU HEAR ABOUT COCHISE How did you hear about Cochise College?High School VisitCareer FairCochise WebsiteInternet AdFamily / FriendMailingNewspaperRadio AdMilitary Education CenterCollege RecruiterMobile App AdOtherIf other, specify 11 - PREVIOUS SCHOOL INFORMATION Previous School InformationHigh School GraduateCurrently Attending High SchoolHome-SchooledGED DiplomaNo High School diploma or GED certificateAdult Ed StudentGradeFreshmanSophomoreJuniorSeniorGraduation DateMM/YYYYExpected Graduation DateMM/YYYYName of High SchoolOnline High School?YesNoName of Middle School (if currently attending)City / State (Province) City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Student Accountability Information System (SAIS) NumberYour 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)?YesNoI consider myself a Lifelong Learner and am not seeking a degree.Non-degree Seeking 000000-0000Which Area of Study are you pursuing?Select OneArts & HumanitiesAviationBehavioral Sciences & Human ServicesBusinessComputer TechnologyHealth SciencesIndustryMilitary ProgramsScience, Technology, Engineering, MathWhich Degree or Certificate?Select OneAZ Gen Ed Curriculum Art Cert 31-44C-AGCADigital Media Arts AAS-DMAFine Arts AA-ARTF; 31-44C-AGCAGeneral Requirements AA-GENG; 31-44C-AGCAGeneral Studies AGS-AGSLiberal Studies (Communication) AA-LBS/LBSC; 31-44C-AGCALiberal Studies (English) AA-LBS/LBSE; 31-44C-AGCALiberal Studies (Humanities) AA-LBS/LBSH; 31-44C-AGCALiberal Studies (Journalism) AA-LBS/LBSJ; 31-44C-AGCALiberal Studies (Philosophy) AA-LBS/LBSP; 31-44C-AGCAMusic AA-MUS; 31-44C-AGCATheatre Arts AA-THE; 31-44C-AGCAWhich Degree or Certificate?Select OneAviation Dispatch AGS-AVDProfessional Pilot Technology (Flight Instructor) AAS-PPT/PPTFProfessional Pilot Technology (Multi-Engine) AAS-PPT/PPTMProfessional Pilot Technology AGS-PPTWhich Degree or Certificate?Select OneAdministration of Justice AA-AJS; 31-44C-AGCAEarly Childhood Care and Education AA-ECE; 31-44C-AGCAEarly Childhood Care and Education AAS-ECEEarly Childhood Care and Education Cert 16-30C-ECECElementary Education AAEE-EED; 31-44C-AGCAFire Science Technology Cert 16-30C-FSTLaw Enforcement (Police Academy) AGS-AGS/ZLEO (Special Admissions)Social Behavioral Sciences (Anthropology) AA-SBS/SBSA; 31-44C-AGCASocial Behavioral Sciences (History) AA-SBS/SBSH; 31-44C-AGCASocial Behavioral Sciences (Political Science) AA-SBS/SBPS; 31-44C-AGCASocial Behavioral Sciences (Psychology) AA-SBS/SBSP; 31-44C-AGCASocial Behavioral Sciences (Sociology) AA-SBS/SBSS; 31-44C-AGCAWhich Degree or Certificate?Select OneAZ Gen Ed Curriculum Business Cert 31-44C-AGCBBusiness Administration ABUS-BUSG; 31-44C-AGCBBusiness Mgmt AAS-BMT/AEWT; Aerospace Welding Technology Cert 16-30C-AEWTBusiness Mgmt AAS-BMT/ASC; Animal Science Cert 16-30C-ASCBusiness Mgmt AAS-BMT/ATC; Automotive Technology Cert 16-30C-ATCBusiness Mgmt AAS-BMT/BKRA; Chef Patissier - Bakers Apprentice Cert 16-30C-BKRABusiness Mgmt AAS-BMT/CAD; Computer-Aided Drafting Cert 16-30C-CADBusiness Mgmt AAS-BMT/CRSC; Crop Science Cert 16-30C-CRSCBusiness Mgmt AAS-BMT/ECEC; Early Childhood Care and Education Cert 16-30C-ECECBusiness Mgmt AAS-BMT/ENTC; Entrepreneurship/Small Business Mgmt Cert 16-30C-ENTCBusiness Mgmt AAS-BMT/FST; Fire Science Technology Cert 16-30C-FSTBusiness Mgmt AAS-BMT/GCAD; General Computer-Aided Drafting Cert 16-30C-GCADBusiness Mgmt AAS-BMT/GWLD; General Welding Technology Cert 16-30C-GWLDBusiness Mgmt AAS-BMT/HSC; Hemp Science Cert 16-30C-HSCBusiness Mgmt AAS-BMT/HCSC; Horticulture Science Cert 16-30C-HCSCBusiness Mgmt AAS-BMT/HVAC; HVAC Cert 16-30C-HVACBusiness Mgmt AAS-BMT/ATCD; Light Vehicle Diesel Cert 1-15C-ATCDBusiness Mgmt AAS-BMT/LSA; Linux System Administrator Cert 16-30C-LSABusiness Mgmt AAS-BMT/MEDA; Medical Assistant Cert 16-30C-MEDABusiness Mgmt AAS-BMT/REFR; HVAC Refrigeration Cert 16-30C-REFERBusiness Mgmt AAS-BMT/RCC; Residential Construction Technology Cert 31-44C-RCCBusiness Mgmt AAS-BMT/SCCA; Sous Chef Apprentice Cert 31-44C-SCCABusiness Mgmt AAS-BMT/SCM; Supply Chain Management Cert 16-30C-SCMBusiness Mgmt AAS-BMT/TAXP; Tax Preparer Cert 16-30C-TAXP (Begins Fall 2022)Business Mgmt AAS-BMT/VRD; Virtual Reality Content Developer Cert 16-30C-VRDBusiness Mgmt AAS-BMT/VRTC; Virtual Reality Technologist Cert 16-30C-VRTCEntrepreneurship/Small Business Management Cert 16-30C-ENTCSupply Chain Management Cert 16-30C-SCMTax Preparer Cert 16-30C-TAXP (Begins Fall 2022)Which Degree or Certificate?Select OneAmazon Web Services Cloud Architecting Cert 1-15C-CLDAAmazon Web Services Cloud Foundations Cert 1-15C-CLDFComputer Information Systems AAS-CISComputer Programming (Programming) AAS-CPG/CPGPComputer Programming (Virtual Reality Development) AAS-CPG/CPGVComputer Science AA-CSC; 31-44C-AGCACybersecurity AAS-CYBGoogle IT Professional Cert 1-15C-GITPLinux System Administrator Cert 16-30C-LSANetwork Technology AAS-NWTVirtual Reality Content Developer Cert 16-30C-VRDVirtual Reality Technologist Cert 16-30C-VRTCWhich Degree or Certificate?Select OneAllied Health AGS-AHS; 31-44C-AGCAEmergency Medical Technician Cert AGS-AHS/; 1-15C-EMTHome Health Aide Cert AGS-AHS; 31-44C-AGCA; 1-15C-HHACMedical Assistant Cert AGS-AHS; 31-44C-AGCA; 16-30C-MEDANursing Assistant Cert AGS-AHS; 31-44C-AGCA; 1-15C-CNAExercise Science, Health, Phys Ed, Recreation and Wellness AA-HPES; 31-44C-AGCANursing (RN) AGS-AHS/ZPRN; 31-44C-AGCA (Special Admissions)Paramedicine AGS-AGS/ZPAR (Special Admissions)Practical Nursing (LPN) Cert AGS-AHS/ZPRN; 31-44C-AGCA (Special Admissions)Which Degree or Certificate?Select OneAutomotive Technology AAS-ATCAutomotive Technology Cert 16-30C-ATCLight Vehicle Diesel Cert 1-15C-ATCDCulinary Arts AAS-CULChef Patissier-Bakers Apprentice Cert 16-30C-BKRASous Chef Apprentice Cert 31-44C-SCCAComputer-Aided Drafting Cert 16-30C-CADGeneral Computer-Aided Drafting Cert 16-30C-GCADHVAC Cert 16-30C-HVACHVAC Refrigeration Cert 16-30C-REFRResidential Construction Technology AAS-RCTResidential Construction Technology Cert 31-44C-RCCWelding Technology AAS-WLDAerospace Thermal Fusion Cert 16-30C-AETFAerospace Welding Technology Cert 16-30C-AEWTGeneral Welding Technology Cert 16-30C-GWLDWhich Degree or Certificate?Select OneIntelligence Operations Studies AAS-IOSTNetwork Technology AAS-NWTUnmanned Aerial Vehicle Flight Operator (Military 15W) AAS-UAVOUnmanned Aircraft Systems Technician (Military 15E) AAS-UAVTWhich Degree or Certificate?Select OneAnimal Science AAS-AGRAAnimal Science Cert 16-30C-ASCAZ Gen Ed Curriculum Science Cert 31-44C-AGCSBiology AS-BIO; 31-44C-AGCSBiology (Human Biology) AS-BIO/BIOA; 31-44C-AGCSChemistry AS-CHM; 31-44C-AGCSComputer Science AS-CSC; 31-44C-AGCSCrop Science AAS-AGRCCrop Science Cert 16-30C-CRSCHemp Science Cert 16-30C-HSCHorticulture Science Cert 16-30C-HCSCEngineering AS-EGR; 31-44C-AGCSGeneral Requirements AS-GENG; 31-44C-AGCSMathematics AS-MAT; 31-44C-AGCSPhysics (Astronomy) AS-PHY/PHYA; 31-44C-AGCSPhysics (Physical Science) AS-PHY/PHYS; 31-44C-AGCSPhysics (Physics) AS-PHY/PHYP; 31-44C-AGCSDo you need to discuss your declared major with an advisor before the start of registration?YesNo13 - INFORMATION RELEASEDo 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?YesNo14 - VERIFICATIONI 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).ReCAPTCHANameThis field is for validation purposes and should be left unchanged.