APPLICATION FOR ADMISSION


To complete this Online Application for Admission, fill out all fields below.  Use the Tab key on your keyboard to move between fields. If some of the fields do not apply to you, do not enter any data.



This is required information.
I. Identification Information

NOTE:  In order to apply electronically, the applicant's Social Security number must be provided.

Social Security Number of Applicant
(Example: 123456789)
RE-ENTER Social Security Number of Applicant
Email Address
(Example:johndoe@somewhere.com)

 

II. Personal Demographic Information

       

Name

  
Legal First Name 


    Middle Initial


     Legal Last Name

       

   

Address


Address Line 1

 
     
 


Address Line 2

   
 
 


     City


  State


     Zip code

 
  County
 
  Country
 
       

Telephone   Number


Telephone
(Example: 9185551234)

       
       

 

III. Request for Confidential Information


The information requested below will be treated as confidential and will be used for summary reports required by federal and state laws and regulations and to support institutional affirmative action efforts. It will not be used as a basis for admission or in a discriminatory manner.

Date of Birth


(MMDDYYYY)

   
       

Gender

Ethnic Background

Please answer all race categories below.
Hispanic/Latino? Yes No
American Indian/Native American? Yes No
Asian? Yes No
Black? Yes No
Hawaiian/Pacific Islander? Yes No
White? Yes No
Marital Status    
   If not, give type of U.S. visa held or to be obtained
  Date of Issue
  
   
   

Are you a Veteran? 

   
   If yes, do you receive VA benefits?  

Are you active military?

   
       

Are you a military dependent?

   
       

 

IV. Educational  Information

Are you entering college for the first time?

   
   If no, enter last college attended
 


 

Your student classification will be:

This application is for

      of     20

   

Will you be attending high school while enrolled at Cisco College?

   

What is your intended Program/Major? Non credit students please choose Non credit. Dual credit students choose "Dual Credit/General Studies".

   

What is your educational intent?

(Only degree and/or certificate-seeking students are eligible for Federal/State Financial Aid.)

 

Which campus do you wish to attend?

If you have a physical or learning disability that may require special accomodations, please contact the Special Populations Coordinator at the location you plan to attend. The Special Populations Coordinator at the Cisco Campus may be reached at 254-442-5023. The Abilene Center Special Pops Coordinator may be reached at 325-794-4406

   

 

V. Educational Background

High School graduation / GED date
(Example:02)
 
   

Are you a former Cisco College student?

   
   

VI. Core Residency Questions


Texas Higher Education Coordinating Board rule 21.25 requires each student applying to enroll at an institution to respond to a set of core residency questions
for the purpose of determining the student's eligibility for classification as a resident.

* PREVIOUS ENROLLMENT (FOR ALL STUDENTS)

1. During the 12 months prior to the term for which you are applying, did you attend a public college or university in Texas in a fall or spring term?

Answer:

2. What Texas public institution did you last attend?

Answer:

 

* RESIDENCY CLAIM

1. Are you a resident of Texas?

Answer:


* ACQUISITION OF HIGH SCHOOL DIPLOMA OR GED

1a. Did you graduate or will you graduate from a high school or complete a GED in TX prior to the term for which you are applying?

Answer:

1b. If you graduated or will graduate from high school what was the name and city of the school?

HS Name:

City:

  State:

2. Did you live or will you have lived in TX the 36 months leading up to the high school graduation or completion of the GED?

Answer:

3. When you begin the semester for which you are applying, will you have lived in TX for the previous 12 months?

Answer:

4. Are you a U.S. Citizen or Permanent Resident?

Answer:


* BASIS OF CLAIM TO RESIDENCY.

To be completed by everyone who did not answer "YES"
to questions 1a, 2 and 3 in ACQUISITION OF HIGH SCHOOL DIPLOMA
OR GED SECTION.

1. Do you file your own federal income tax as an independent tax payer?

Answer:

2. Are you claimed as a dependent or are you eligible to be claimed
as a dependent by a parent or court-appointed legal guardian?

  • To be eligible to be claimed as a dependent, your parent or legal guardian must provide
    at least one-half of your support. A step-parent does not qualify as a parent if he/she
    has not adopted the student.

Answer:

3. If you answered "NO" to both questions above, who provides the majority of your support?

Answer:

Other Source of Support:


* QUESTIONS FOR STUDENTS WHO ANSWERED "YES" TO QUESTION 1
OR "SELF" TO QUESTION 3 IN THE BASIS OF CLAIM TO RESIDENCY SECTION

1. Are you a foreign national whose application for Permanent Resident Status has been preliminarily reviewed?

  • You should have received a fee/filing receipt or Notice of Action (I-797)
    from USCIS showing your I-485 has been reviewed and has not been rejected.

Answer:

2. Are you a foreign national here with a visa or are you a Refugee, Asylee, Parolee or here under Temporary Protective Status? If so, indicate which.

Answer:

3. Do you currently live in Texas?

  • If you are out of state due to a temporary assigment by your employer
    or another temporary purpose, please answer "NO" and explain in the GENERAL COMMENTS below.

Answer:

4a. If you currently live in Texas, how long have you been living here?

Answer:

4b. What is your main purpose for living in the state?

  • If for reasons other than those listed below, please explain in the GENERAL COMMENTS section below.

Answer:

5a. If you are a member of the U.S. Military, is Texas your Home of Record?

Answer:

5b. If not, what state will have been listed as your military legal residence for tax purposes on your Leave and Earnings Statement for the 12 months prior to enrollment?

State:

6a. Hold the title (Warranty, Deed, Deed of Trust, or other similar instrument that is effective to hold title) to residential real property in Texas?

Answer:

If "YES", date acquired (MMDDYYYY)?      

6b. Do you have ownership interest and customarily manage a business in Texas without the intention of liquidation in the forseeable future?

Answer:

If "YES", date acquired (MMDDYYYY)?      

7a. While living in Texas, have you been Gainfully Employed for a period of at least 12 consecutive months?

  • Gainful Employment requires an average employment of at least 20 hours per week
    for one year or earnings equal to at least half of tuition and living expenses for
    one 9-month academic year. Employment conditioned on student status such as
    work-study, the receipt of stipends, fellowships or reseach or teaching assistanceships
    does not constitute gainful employment.

Answer:

7b. While living in Texas, have you received primary support from a social service agency for a period of at least 12 consecutive months?

Answer:

8a. Are you married to a person who has been classified as a Texas resident by a Texas public institution or who could answer "YES" to any part of question 6 or 7?

Answer:

8b. If "YES" on question 8a, indicate which question (and which part of the question) could be answered "YES" by your spouse.

     

8c. How long will you have been married to the Texas resident prior to enrollment?

Answer:


* QUESTIONS FOR STUDENTS WHO ANSWERED "YES" TO QUESTION 2
OR "PARENT OR GUARDIAN" TO QUESTION 3 IN THE BASIS OF CLAIM TO RESIDENCY SECTION

1. Is the parent or legal guardian upon who you base your claim of residency a U.S. Citizen?

Answer:

2. Is the parent or legal guardian upon who you base your claim of residency a Permanent Resident?

Answer:

3. Is the parent or legal guardian a foreign national whose application for Permament Resident Status has been preliminarily reviewed?

  • He or she should have received a fee/filing receipt or Notice of Action (I-797)
    from USCIS showing your I-485 has been reviewed and has not been rejected.

Answer:

4. Is the parent or legal guardian a foreign national here with a visa or are you a Refugee, Asylee, Parolee or here under Temporary Protective Status? If so, indicate which.

Answer:

5. Does the parent or legal guardian currently live in Texas?

  • If he or she is out of state due to a temporary assigment by your employer
    or another temporary purpose, please answer "NO" and explain in the GENERAL COMMENTS below.

Answer:

6a. If he or she is currently living in Texas, how long has he or she been living here?

Answer:

6b. What is your parent or legal guardian's main purpose for living in the state?

  • If for reasons other than those listed below, please explain in the GENERAL COMMENTS section below.

Answer:

7a. If he or she is a member of the U.S. Military, is Texas his or her Home of Record?

Answer:

7b. If not, what state will have been listed as his or her military legal residence for tax purposes on his or her Leave and Earnings Statement for the 12 months prior to enrollment?

State:

8a. Does the parent or guardian hold the title (Warranty, Deed, Deed of Trust, or other similar instrument that is effective to hold title) to residential real property in Texas?

Answer:

If "YES", date acquired (MMDDYYYY)?      

8b. Does the parent or guardian have ownership interest and customarily manage a business in Texas without the intention of liquidation in the forseeable future?

Answer:

If "YES", date acquired (MMDDYYYY)?      

9a. While living in Texas, has your parent or guardian been Gainfully Employed for a period of at least 12 consecutive months?

  • Gainful Employment requires an average employment of at least 20 hours per week
    for one year or earnings equal to at least half of tuition and living expenses for
    one 9-month academic year. Employment conditioned on student status such as
    work-study, the receipt of stipends, fellowships or reseach or teaching assistanceships
    does not constitute gainful employment.

Answer:

9b. While living in Texas, has your parent or legal guardian received primary support from a social service agency for a period of at least 12 consecutive months?

Answer:

10a. Is the parent or legal guardian married to a person who has been classified as a Texas resident by a Texas public institution or who could answer "YES" to any part of question 6 or 7?

Answer:

10b. If "YES" on question 10a, indicate which question (and which part of the question) could be answered "YES" by your parent or legal guardian's spouse.

     

10c. How long will your parent or guardian have been married to the Texas resident prior to enrollment?

Answer:


* GENERAL COMMENTS

Please enter any general comments you have in the space below.



* CERTIFICATION OF RESIDENCY

I understand that officials of my college/university will use the information submitted on
this form to determine my status for residency eligibility. I authorize the college/university
to verify the information provided. I certify that the information on this application is complete
and correct and I understand that the submission of false information is grounds for rejection of my
application, withdrawal if any offer of acceptanace, cancellation of enrollment and/or appropriate
disciplinary action.

Type your name here to acknowledge your Residency Certification:

VII. Special Populations


Please answer the items below which best describe your current circumstance. The information provided will only be used for reporting purposes, as mandated by the state.

1. Are you an Individual with disabilities (defined as a student who meets any of these criteria)?

  • You have been referred by the Department of Assistive and Rehabilitative Services for education and training.
  • You receive services through a special populations state program.

Answer:

 

2. Do you have limited English speaking ability?

An adult or an out-of-school youth who has limited ability in speaking, reading, writing, or understanding the English language and
  • Whose native language is a language other than English; or
  • Who lives in a family environment in which a language other than English is the dominant language.

Answer:

 

3. Were you a homemaker, not working outside the home, prior to this enrollment?

Answer:

 

4. Are you a Single Parent?

Answer:

 

5. Are you a Homeless Individual?

  • Broadly means individuals who lack a fixed, regular, and adequate night time residence.

Answer:

 

6. Are you currently a youth that is in or have aged out of the foster care system?

  • "Youth" means an individual who is not younger than age 17 or older than age 24.

Answer:

 

7. Are you a youth with a parent who is a member of the armed forces or is on active duty?

  • "Youth" means an individual who is not younger than age 17 or older than age 24.

Answer:


I certify that the information provided in this Application for Admission is complete and accurate to the best of my knowledge. I further understand that this information will be relied upon by the officials of the college in determining my admission and residence status for tuition purposes and that the submission of false information is grounds for rejection of my application, withdrawal of an offer of acceptance, cancellation of enrollment, and/or disciplinary action. I agree to conform to and abide by the letter and the spirit of all policies, rules, and regulation of Cisco College.

Admission to Cisco College is open to all qualified persons regardless of race, creed, color, sex, disability, age, religion or national origin.

When you have completed the Online Application for Admission, click the "Submit" button ONE TIME ONLY.

  


[ Return to the Summary of Admissions Procedures Page ]

 

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