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Maricopa Community Colleges Student Information Form

* = required field


Maricopa Community Colleges
Student Information Form
Applicant Information

Term of Enrollment: * Year: *
College or Skill Center: *
Legal Name - Last:    * First: * Middle:
Date of Birth: * Gender**: * Social Security Number:
    (numbers only)
Your Social Security Number will not be used as your primary student identification number and will be kept confidential. Providing a Social Security Number will ensure that your educational records are complete and correct and will allow the fullest services. Any individuals that wish to gain full access to Maricopa’s secure online self-services resources must provide both the Social Security Number and date of birth. Students should be aware that a correct Social Security Number must be on file for reporting information pertaining to potential tax credit, and must be used by applicants for federal and state aid, and Veteran Administration benefits. Failure to provide a correct Social Security Number may preclude the determination of eligibility for in-state residence, resulting in out-of-state tuition.
Information Release
Do you give permission for the college to release directory information relative to your enrollment (as per the the Family Education Rights and Privacy Act of 1974)?

Contact Information

Address:     * Apt #:
* State: * Zip: *
Telephone Number: Home - Other -
Email Address: Home - Confirm Email Address: Other -

Demographic Information

Are you applying for instate tuition? *
Do you possess an AZ Department of Motor Vehicle License or AZ Photo ID? *
*These questions are asked for the purpose of determining tuition. Pursuant to A.R.S. §§1-502, 15-1802, 15-1802.01, 15-1803, a person who is not lawfully present in the United States is not entitled to classification as an in-state/in-county student. All applicants for resident tuition and/or financial aid must submit documentation of the above status and any additional proof of residency to the admissions/enrollment services staff upon request. Applicants for resident tuition who fail to answer the above questions or to submit supporting documentation as requested are automatically assessed nonresident tuition. Any student who falsifies information used to establish residency for tuition purposes shall be required to pay full tuition and may be subject to dismissal from the college and/or criminal action. Refer to or the college catalog for residency guidelines.

Do you consider yourself to be Hispanic/Latino? *
** Voluntary information used to comply with Federal Reporting and has no effect on admission to the college. This information will not be used for any discriminatory purpose.

Previous Education

High School Status: *
Previous College (check highest level completed): *

First Generation College Student

Are you a first generation college student? *
You are a first generation student if both parents or guardians (parent or guardian if only living with one) did not complete a bachelor’s degree.

Language Background

What was the first language you spoke as a child? *
What languages were spoken in your home when you were growing up? *
What language do you speak most often now? *
Do you wish assistance with English fluency skills? *


Are you currently a member of the US Armed Forces stationed in Arizona pursuant to military orders? *
Are you a dependent of a member of the US Armed Forces stationed in Arizona pursuant to military orders? *
Are you a Veteran of the US Armed Forces? *


Final residency decisions for tuition purposes will be made in accordance with A.R.S. 15-1801 and regulations of the Maricopa Community College Governing Board.
Will you reside in Arizona at the time of attendance? *
Are you seeking admission under the Western Undergraduate Exchange program? *

Education Plan

Select a primary reason for attending this college: *

Academic Plan

What academic plan do you intend to earn from this college?


By submitting this form, I acknowledge that document(s) will be required to demonstrate lawful presence in the United States and the information provided on this form is true and complete.

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