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 admissions@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 - Student Information

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.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Telephone
Email Address*
Enter Email Confirm Email
In Case of Emergency - Name
Emergency Phone
3 - ENROLLMENT INFORMATION
Year you plan to enter Cochise College:
Semester you plan to enter Cochise College:
Student Type
4 - BIOGRAPHICAL INFORMATION
Gender
Date of Birth*
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 (List of Acceptable Documents PDF).

Documents can be scanned/uploaded below, emailed to admissions@cochise.edu or mailed or submitted in person to the Admissions Office at: Cochise College, Admissions Office, 901 North Colombo Ave., Sierra Vista, AZ 85635-2317.
Citizenship
If other, specify country
Type of Visa
If other, specify visa type
6 - RESIDENCY INFORMATION
Failure to answer any question may 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?

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

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

Expected Graduation Date

Name of 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.
To have transfer work evaluated, official transcripts must be requested from each institution and sent directly to Cochise College.

12 - DEGREES AND CERTIFICATES

Which degree or certificate are you pursuing?
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*

Disability Services: If you have a disability and require auxiliary aids, services, or other accommodations as a student at Cochise College, please contact the Disability Services Office at (520) 515-5337 or (520) 417-4023.

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.
Email
This field is for validation purposes and should be left unchanged.

This application must be completed for admission or re-entry to Cochise College.

Step 1 of 4 - Student Information

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