Texas A&M University-Commerce, Graduate Studies

Application for Readmission

Graduate Studies, P.O. Box 3011, Texas A&M University-Commerce, Commerce, Texas 75429-3011 or Fax: 903/886-5165.

I plan to enroll at A&M-Commerce in 20__:  Fall  Spring  Summer I  Summer II  May Mini  August Mini  Winter Mini

Student id no. (CWID) Last year attended

A D M I S S I O N S T A T U S ---- A&M-Commerce is an Equal Opportunity University

 Domestic student  International Student

Indicate degree and program for readmission (must readmit to same program previously attended; if applying to new program, please use Apply Texas application at:

 Master’s Degree  Doctoral Degree  Specialist Degree

Major:_____

 Teacher Certification  Nondegree (not seeking degree)

P E R S O N A L D A T A

Name (print)

LastFirstMiddle

Address

StreetApt.CityStateZip

County of Residence Other last names

Cell Phone ()______Home Phone ()_____ Date of Birth______

Month/Day/Year

E-mail Address

 Male Female Single Married

 Native American African American Asian American Hispanic Caucasian

With few exceptions, you have the right to request, receive, review, and correct information about yourself collected by this form.

R E S I D E N C Y

Are you a U.S. Citizen? Yes No Permanent Resident

If no, what is your country of citizenshipType of Visa

U.S. Citizen or Permanent Resident applicants:

Is Texas your state of residence? Yes No

Upon whom are you basing residency? Self Parent  Guardian

How long have you resided in Texas? Years+ Months Previous state or country of residence

If you came here within the past 5 years, why did you move to Texas? Education  Employment  Other (specify)

If you selected No in response to “Are you a U.S. Citizen?” or you selected Permanent Resident then you must complete the questionnaire below. Attach a copy of your visa or permanent resident documentation and proof of living in Texas for the past 12 months such as a pay stub.

O A T H O F R E S I D E N C Y

I understand that information submitted herein will be relied upon by Texas A&M University-Commerce to determine my status for admission and residency eligibility. I authorize A&M-Commerce to verify the information I have provided. I certify that the information on this application is complete and correct and understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment, or disciplinary action.

Signature of ApplicantDate

CoreResidencyQuestions

TheTexasHigherEducation CoordinatingBoardrule21.731requireseachstudent applyingto enrollatan institution to respondto a setof coreresidencyquestionsfor thepurpose of determiningthestudent’seligibilityforclassificationas a resident.

PARTA:STUDENTBASICINFORMATION.

Name:

StudentID Number:

Dateof Birth:

Address:

Previous address:

PARTB:PREVIOUSENROLLMENT. Forallstudents.

1. During the12monthspriortothetermforwhichyouareapplying,did youattenda public collegeoruniversityin Texasin a fall orspringterm?

Yes

No

Ifyouanswered“No”,pleasecontinuetoPART C.If youanswered“Yes”,complete questions2-5:

2. What Texaspublicinstitution did youlastattend?(Givefull name,notjustinitials.)

3. Inwhichtermswereyoulastenrolled?(checkall thatapply)

Fall,20

Spring,20

4. During yourlastsemesterata Texaspublicinstitution,did youpayresident(in-state)or nonresident(out ofstate)?

Resident(in-state)Nonresident(outofstate)Unknown

5. Ifyoupaid in-statetuition atyourlastinstitution,wasitbecauseyouwereclassifiedas a residentorbecauseyouwerea nonresidentwhoreceivedawaiver?

Resident(in-state)Nonresident(outofstate)Unknown

IMPORTANT:Ifyouwereenrolledata Texaspublic institutionduringa Fall orSpring semesterwithin theprevious12monthsand wereclassifiedas a Texasresident,skipto

PARTI,signand datethis formand submitittoyourinstitution.Ifyouwerenotenrolled,or if youwereenrolledbutclassifiedas a nonresident,proceedtoPARTC.

PARTC: RESIDENCYCLAIM

Areyoua residentof Texas? YesNo

Ifyouansweredyes,continuetoPARTD.

Ifyouansweredno,completethefollowing questionand continuetoPARTI.

Of whatstateorcountryareyoua resident?If youareuncertain,continuetoPARTD.

PARTD:ACQUISITIONOF HIGHSCHOOLDIPLOMAOR GED

YES / NO
1. (A)Did yougraduateorwillyougraduatefromhigh school or completeaGEDin TX priortothetermforwhichyouare applying?
1. (B)Ifyougraduated,orwill graduatefromhighschool,whatwas
thenameand cityof theschool?
2. Did youlive,orwill you havelivedin TX the36monthsleadingup
tohighschoolgraduationorcompletionof theGED?
3. Whenyoubeginthesemesterforwhichyouareapplying,will you havelivedin TX fortheprevious12months?
4. Areyoua U.S.Citizen orPermanentResident?

InstructionstoPARTD:

•If youanswered“no” toquestion 1(A)or2or3,continueto PARTE.

•Ifyouanswered“yes”toall four questions,skiptoPARTI.

•Ifyouanswered“yes”toquestions1,2,and 3but “no” toquestion4,completea copy of theAffidavitin ChartIII,providedas an Attachmenttothis form,skip toPART Iof this form,and submitboth thisformandtheaffidavittoyourinstitution.

PART E:BASISOFCLAIMTORESIDENCY

Tobecompletedby everyonewhodidnotanswer“Yes”to questions1a,2, and3 ofPARTD.

1. Doyoufileyour own federalincometaxas an independenttaxpayer?YesNo

2. Areyouclaimedas a dependentorareyoueligibletobeclaimedas a dependentbya parentorcourt-appointedlegalguardian?Yes No(To beeligible tobeclaimedas a dependent,yourparentorlegalguardianmustprovideatleastonehalf of your

support.Astep-parentdoesnotqualifyas a parentif he/shehas notadoptedthe student.)

3. Ifyouanswered“No”tobothquestionsabove,whoprovidesthemajorityof your support? Self ParentorGuardian Other:

InstructionstoPartE:

•Ifyouanswered“yes”toquestion 1,continuetoPARTF.

•Ifyouanswered“yes”toquestion 2,skip to PART G.

•Ifyouanswered“no” to1and 2and “self”toquestion 3,continuetoPARTF.

•Ifyouanswered“no” to1and 2and “parentorguardian”toquestion 3,skip to

PART G.

•Ifyouanswered“no” to1and 2and “other”toquestion 3,skip toPARTHand providean explanation,and completePARTI.

PARTF:QUESTIONSFORSTUDENTSWHOANSWERED“YES”TOQUESTION1OR“SELF”TO QUESTION3OF PARTE.

Yes / No / Years / Months / VisaStatus
1. Areyoua U.S.Citizen?
2. Areyoua PermanentResidentof the
U.S.?
3. Areyoua foreignnationalwhose applicationforPermanentResident Statushas beenpreliminarily reviewed?(youshouldhavereceived a fee/filingreceiptorNoticeof
Action(I-797)fromUSCIS showing yourI-485has beenreviewedand has notbeenrejected).
4. Areyoua foreignnationalherewith
a visa orareyoua Refugee,Asylee, ParoleeorhereunderTemporary ProtectiveStatus?Ifso, indicate which.
5. DoyoucurrentlyliveinTexas?Ifyou
areout of statedue toa temporary assignmentbyyouremployeror othertemporarypurpose,please explainin PARTH.
6. (A)IfyoucurrentlyliveinTexas,how
longhaveyoubeenlivinghere? / Months / Years
(B)Whatis yourmainpurposeforbeing
inthestate?Ifforreasonsotherthan thoselisted,giveanexplanationinPART H. / GotoCollege
[] / Establish/maintain
ahome
[] / Work
Assignment
[]
7.Ifyouarea memberoftheU.S.military,
isTexasyourHomeofRecord?
Whatstateis listedasyourmilitarylegalresidencefortaxpurposesonyourLeaveandEarningsStatement? / Yes / No
State
YES / NO
8. Doanyofthefollowingapplytoyou?(checkallthatapply)
a) Holdthetitletorealproperty(home,land)inTexas?
Ifyes,dateacquired:
b) Owna businessinTexas?
Ifyes,dateacquired:
c)Holdastateoflocallicensetoconductabusinessorpracticea professionin Texas?
Ifyes,dateacquired:
9. WhilelivinginTexas,haveyou(checkallthatapply)
a) Beengainfullyemployedforatleasta consecutive12-month
period?
b) Receivedservicesfroma socialserviceagencythatprovides servicestohomelesspersonsforatleastaconsecutive12-month period?
10.(A)Areyoumarriedtoa personwhocouldanswer“yes”toanypartof question8 or9?
(B)Ifyes,indicatewhichquestioncouldbeansweredbyyourspouse: (C)HowlonghaveyoubeenmarriedtotheTexasresident?
Question#:
Months / Years

IfyouansweredPARTFthenskip PARTGand continuetoPARTH

PART G:QUESTIONSFORSTUDENTSWHOANSWERED“PARENTOR LEGALGUARDIAN”TO QUESTION3OF PARTE.

Yes / No / Years / Months / VisaStatus
1. Istheparentof legalguardianupon
whomyoubaseyourclaimof residencyaU.S.Citizen
2. Is theparentorlegalguardianupon
whomyoubaseyourclaimof residencyaPermanentResident?
3. Isthisparentorlegalguardiana foreignnational whoseapplication forPermanentResidentStatushas beenpreliminarilyreviewed?(He or sheshould havereceiveda fee/filing receiptorNoticeof Action(I-797)
fromtheUSCISshowinghis orherI-
485hasbeenreviewedand has not beenrejected).
4. Isthisparentorlegalguardiana
foreignnationalherewitha visa or areyoua Refugee,Asylee,Paroleeor hereunderTemporaryProtective Status?Ifso,indicatewhich.
5. Doesthis parentorlegalguardian
currentlylivein Texas?Ifhe orsheis out ofstatedue toa temporary assignmentby his/heremployeror othertemporarypurpose,please explainin PARTH.
6. (A)If he/sheiscurrentlyliveinTexas, howlonghashe/shebeenlivinghere? (B)Whatis yourparent’sorlegal
guardian’smainpurposeforbeinginthe state?If forreasonsotherthanthose listed,giveanexplanationinPARTH. / Months / Years
GotoCollege
[] / Establish/maintain
ahome
[] / Work
Assignment
[]
7.Ifhe/sheisa memberoftheU.S.
military,is Texashis/herHomeof
Record?
Whatstateis listedas his/hermilitary legalresidencefortaxpurposeson his/herLeaveandEarningsStatement? / Yes / No
State
YES / NO
8. Doanyofthefollowingapplytoyourparentorguardian?(checkall
thatapply)
a) Holdthetitletorealproperty(home,land)inTexas?
Ifyes,dateacquired:
b) Owna businessinTexas?
Ifyes,dateacquired:
c)Holdastateoflocallicensetoconductabusinessorpracticea professionin Texas?
Ifyes,dateacquired:
9. WhilelivinginTexas,hasyourparentorguardian:(checkallthatapply)
a) Beengainfullyemployedforatleasta consecutive12-month
period?
b) Receivedservicesfroma socialserviceagencythatprovides servicestohomelesspersonsforatleastaconsecutive12-month period?
10.(a)Isyourparentorlegalguardianmarriedtoa personwhocould
answer“yes”toanypartofquestion8or9?
(b)If yes,indicatewhichquestioncouldbeansweredbyyourparentor legalguardian’sspouse:
(c)Howlonghasyourparentorlegalguardianbeenmarriedtothe
Texasresident?
Question#:
Months / Years

PARTH:GENERALCOMMENTS:Isthereanyadditional informationthatyoubelieveyour collegeshould knowin evaluatingyoureligibilitytobeclassifiedas a resident?Ifso,please provideitbelow:

PARTI: CERTIFICATION OFRESIDENCY AND APPLICATION INFORMATION:

All students must complete this section

I understand that officials of Texas A&M University-Commerce will use the information submitted on this form to determine my status for admission and residency eligibility. I authorize Texas A&M University-Commerce to verify the information I have provided. I agree to notify the proper officials of Texas A&M University-Commerce of any changes in the information provided. I certify that the information on this document is complete and correct and I understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment and/or appropriate disciplinary action.

______

Signature Date