CUYAMACA COLLEGE
SUPPLEMENTARY APPLICATION FOR ADMISSION
(Applicant under 19 years of age and have not been married)
Student’s last name
First
MI
Student ID #
To determine your resident status the following information is needed. Additionally, you may be requested to submit
documentation to accurately determine your status.
1.
Have your parents lived in California less than two years? ☐Yes ☐No
2.
Have your parents done any of the following OUTSIDE OF CALIFORNIA during the last two years?
Obtained a driver’s license
☐Yes ☐No
Filed state taxes
☐Yes ☐No
Registered to vote
☐Yes ☐No
Petitioned for divorce
☐Yes ☐No
Attended an educational institutional as a resident ☐Yes ☐No
Are either of your parents active military?
☐Yes ☐No
3.
4.
What is your parents citizenship status:
☐U.S. Citizen
☐Permanent Resident Immigrant Issue date:
☐Non Immigrant
Visa type:
☐Other
5.
Do you live with a natural parent(s)? ☐Yes ☐No (If yes, sign and date. If no, answer questions 6-8.)
6.
Which parent did you last live with? ☐Mother ☐Father
7.
Where do your parents reside?
Father
Mother
City and State
Name of legal guardian you live with. (if self, enter “SELF”)
Name
Relationship
8.
City and State
Since what date have you resided with this person?
Is this person a:
☐U.S. Citizen
☐Permanent Resident Immigrant Issue date:
☐Non Immigrant
Visa type:
☐Other
Does this person claim California as their legal residence? ☐Yes ☐No
If yes, since what date?
I declare under penalty of perjury that all information on this form is correct. I understand that falsification or withholding
information may constitute grounds for dismissal.
Signature
Date