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 firstname.lastname@example.org. 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*(###) ###-####May we text you?*YesNoPrimary Telephone, if different from cell phone number.(###) ###-####Email Address* Enter Email Confirm Email In Case of Emergency - NameEmergency Phone(###) ###-#### 3 - ENROLLMENT INFORMATIONYear you plan to enter Cochise College:Semester you plan to enter Cochise College:Fall I / AugustFall II / OctoberSpring I / JanuarySpring II / MarchSummer I / MayStudent TypeHigh 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 email@example.com 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.Not Seeking Degree/Lifelong Learning 000000-LLLWhich Area of Study are you pursuing?Select OneArts & HumanitiesBehavioral Sciences & Human ServicesBusinessComputer TechnologyHealth SciencesIndustryScience, Technology, Engineering, MathAdditional Credential OptionsWhich Degree or Certificate?Select OneFine Arts AA-ARTF; 31-44C-AGCAGeneral Requirements AA-GENG; 31-44C-AGCALiberal 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-AGCAMedia Production Arts AAS-MPAMusic AA-MUS; 31-44C-AGCATheatre Arts AA-THE; 31-44C-AGCAWhich Degree or Certificate?Select OneAdministration of Justice AA-AJS; 31-44C-AGCACulinary Arts AAS-CULChef Patissier - Bakers Apprentice Certificate 16-30C-BKRASous Chef Apprentice Certificate 31-44C-SCCAEarly Childhood Care and Education AA-ECE; 31-44C-AGCAEarly Childhood Care and Education AAS-ECEEarly Childhood Care and Education Certificate 16-30C-ECECElementary Education AAEE-EED; 31-44C-AGCAEmergency Medical Technician Cert AGS-AGS/PAR; 1-15C-EMTFire Science Technology Certificate 16-30C-FSTLaw Enforcement (Police Academy) AGS-AGS/ZLEO (Special Admissions)Paramedicine AGS-AGS/ZPAR (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 OneBusiness Administration ABUS-BUSG; 31-44C-AGCBBus Mgmt AAS-BMT/AETF; Aerospace Thermal Fusion Cert 16-30C-AETFBus Mgmt AAS-BMT/AEWT; Aerospace Welding Tech Cert 16-30C-AEWTBus Mgmt AAS-BMT/ASC; Animal Science Cert 16-30C-ASCBus Mgmt AAS-BMT/ATC; Automotive Tech Cert 16-30C-ATCBus Mgmt AAS-BMT/CTC; Carpentry Tech Cert 16-30C-CTCBus Mgmt AAS-BMT/BKRA; Chef Patissier - Bakers Apprent Cert 16-30C-BKRABus Mgmt AAS-BMT/CAD; Computer-Aided Drafting Cert 16-30C-CADBus Mgmt AAS-BMT/CRSC; Crop Science Cert 16-30C-CRSCBus Mgmt AAS-BMT/ECEC; Early Childhood Care and Educ Cert 16-30C-ECECBus Mgmt AAS-BMT/ENTC; Entrepreneurship/Small Bus Mgmt Cert 16-30C-ENTCBus Mgmt AAS-BMT/FST; Fire Science Tech Cert 16-30C-FSTBus Mgmt AAS-BMT/GCAD; Gen Computer-Aided Drafting Cert 16-30C-GCADBus Mgmt AAS-BMT/GWLD; Gen Welding Tech Cert 16-30C-GWLDBus Mgmt AAS-BMT/HCSC; Horticulture Science Cert 16-30C-HCSCBus Mgmt AAS-BMT/HVAC; HVAC Cert 16-30C-HVACBus Mgmt AAS-BMT/LSA; Linux System Administrator Cert 16-30C-LSABus Mgmt AAS-BMT/MEDA; Medical Assistant Cert 16-30C-MEDABus Mgmt AAS-BMT/RCC; Residential Construction Tech Cert 31-44C-RCCBus Mgmt AAS-BMT/SCCA; Sous Chef Apprentice Cert 31-44C-SCCABus Mgmt AAS-BMT/TEF; Tech Educ Facilitator (Military) Cert 16-30C-TEFBus Mgmt AAS-BMT/UASO; Unmanned Aircraft Sys Ops (HS Students) 16-30C-UASOBus Mgmt AAS-BMT/VRTC; Virtual Reality Technologist Cert 16-30C-VRTCBus Mgmt AAS-BMT/WLD; Welding Tech Cert 16-30C-WLDEconomics AA-ECN; 31-44C-AGCAEntrepreneurship/Small Bus Mgmt Cert 16-30C-ENTCSupply Chain Mgmt Cert 16-30C - SCMWhich Degree or Certificate?Select OneComputer Information Systems AAS-CISComputer Programming AAS-CPGComputer Science AA-CSC; 31-44C-AGCACybersecurity AAS-CYBLinux System Administrator Cert 16-30C-LSANetwork Tech AAS-NWTWhich Degree or Certificate?Select OneAllied Health Degree AAS-AHS; 31-44C-AGCAEmergency Medical Technician Cert AAS-AHS; 31-44C-AGCA; 1-15C-EMTHome Health Aide Cert AAS-AHS; 31-44C-AGCA; 1-15C-HHACMedical Assistant Cert AAS-AHS; 31-44C-AGCA; 16-30C-MEDANursing (LPN to RN Adv Pathway) AAS-AHS/NUR; 31-44C-AGCA (Special Admissions)Nursing Assistant Cert AAS-AHS; 31-44C-AGCA; 1-15C-CNAPractical Nursing AAS-AHS; 31-44C-AGCA (Special Admissions)Exercise Science, Health, Phys Ed, Recreation & Wellness AA-HPES; 31-44C-AGCAWhich Degree or Certificate?Select OneAerospace Thermal Fusion Cert 16-30C-AETFAerospace Welding Tech Cert 16-30C-AEWTAutomotive Tech AAS-ATCAutomotive Tech Cert 16-30C-ATCAviation Dispatch AGS-AVDComputer-Aided Drafting Cert 16-30C-CADGeneral Computer-Aided Drafting Cert 16-30C-GCADGeneral Welding Tech Cert 16-30C-GWLDHVAC Cert 16-30C-HVAProfessional Pilot Tech (Flight Instructor) AAS-PPT/PPTFProfessional Pilot Tech (Multi-Engine) AAS-PPT/PPTMProfessional Pilot Tech AGS-PPTResidential Construction Tech AAS-RCTResidential Construction Tech Cert 31-44C-RCCWelding Tech AAS-WLDWelding Tech Cert 16-30C-WLDWhich Degree or Certificate?Select OneAnimal Science AAS-AGRAAnimal Science Cert 16-30C-ASCBiology 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-CRSCEngineering AS-EGR; 31-44C-AGCSGeneral Requirements AS-GENG; 31-44C-AGCSHemp Science Cert 16-30C - HSCHorticulture Science Cert 16-30C-HCSCMathematics 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-AGCSWhich Degree or Certificate?Select OneAZ Gen Ed Curriculum Art Cert 31-44C-AGCAAZ Gen Ed Curriculum Bus Cert 31-44C-AGCBAZ Gen Ed Curriculum Science Cert 31-44C-AGCSGeneral Studies AGS-AGSIntelligence Ops Studies AAS-IOSTTechnical Education Facilitator (Military) Cert 16-30C-TEFUnmanned Aerial Vehicle Flight Operator (Military 15W) AAS-UAVOUnmanned Aircraft Systems Ops (HS Students) 16-30C-UASOUnmanned Ground Vehicle Technician 16-30C - UGVTUnmanned Aircraft Systems Technician (Military 15E) AAS-UAVTVirtual Reality Content Developer 16-30C-VRDVirtual Reality Technologist Cert 16-30C-VRTCDo 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 ReCAPTCHADisability 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).PhoneThis field is for validation purposes and should be left unchanged.