San Juan College - Student Update

Current Name

First

Middle

Last

SJC Colleague ID#

Date Of Birth (mm/dd/yyyy)

Social Security Number (SSN)

New Legal Name

Change Name?

Legal First

Legal Middle

Legal Last

Maiden

NOTE: The student must submit legal documents in support of name change: driver's license, social security card, marriage license or divorce decree. Copies of your documentation may be submitted to: admissions@sanjuancollege.edu or 505-566-3500 RE: Name Change.

Current Mailing Address

Street

City

State

Zip Code

Phone

Phone Type Home Cell Alternate

Emergency Contact (Not Yourself)

Contact Name

Relationship to Student

Phone Number

Status Update

NOTE: If you are changing your status from Non-Degree Seeking to Degree Seeking, you must be in Good Standing at San Juan College, and have a cumulative grade point average of all higher education work of 2.0 or above.

Change of Major? Yes No

I wish to be:

: Still in High School and am Dual Credit
: Degree Seeking (Choose degree type)
: Non-Degree Seeking

Area of Interest

Degree Type:

Start Term What term do you plan to start or return (ex. Fall 2010)

Education

NOTE: If you are changing from non-degree seeking to degree-seeking, you agree to provide official transcripts (high school/GED and college). If you have completed at least 15 college-level credits with a cumulative 2.0 or higher GPA, you do not have to provide a high school/GED transcript.

High School Graduate? Yes No Not Yet

Name of High School
City & State Issued
Graduation Year

If No, did you earn a GED? Yes No

City & State Issued

Issue Date

Colleges & Universities Attended

Please list any colleges or universities attended. If you have left San Juan College and are now returning, please list any other institutions you may have attended during that time period. NOTE: You do not need to list San Juan College as an institution you have attended.

Institution Name Dates of Attendance
Institution Name Dates of Attendance
Institution Name Dates of Attendance
Institution Name Dates of Attendance

I certify that I am eligible to attend or return to the institution of higher education which I last attended and that this change of status will require that I accept the degree or certificate requirements as outlined in the catalog in effect at the time of the change from non-degree to degree seeking status.

Residency Information

If you are claiming New Mexico residency for tuition purposes, you MUST NOT have a driver's license, vehicle registration or voter registration in another state. If you ever attended San Juan College under non-residency status, YOU must petition for in-state residency with the Enrollment Services office.

You MUST answer the following questions: (If you want to change your residency status see the SPECIAL RESIDENCY STATUS conditions below, request the correct form and provide the proper documentation.

Special Residency Status

If you have resided in New Mexico for 12-months and wish to change your residency status please fill out the Petition for In-State Tuition Classification form. Ask the Enrollment Services office for the Petition for In-State Tuition Classification form.
Native American students who are members of the Navajo Nation tribe may apply for a waiver of non-resident tuition and, if approved, be admitted under resident tuition status. To be eligible, submit a in a copy of your Certificate of Indian Blood to the Enrollment Services office.
Colorado Residents residing in one of the following counties: Montezuma, La Plata, Archuleta, Dolores, or San Juan County, may apply for the Colorado-New Mexico tuition exchange program. The student must be eligible for resident tuition in Colorado to be eligible for this program. Ask the Enrollment Services office for the Colorado-New Mexico Tuition Exchange Program form.
The student, spouse or dependents, of a person who have moved to New Mexico and can provide documentation of permanent full-time employment, may be eligible for a waiver of the 12-month durational requirement. Ask the Enrollment Services office for the Request for New Mexico Residency Based on Full-Time Employment form.
Any person, his or her spouse or dependent child, not otherwise entitled to claim residence who is a member of the armed forces of the United States or armed forces of a foreign country assigned to active duty in the state of New Mexico will be assessed resident tuition rates.
Active Duty New Mexico National Guard members shall be deemed a resident for purposes of determining tuition.

By typing my full name I certify to the best of my ability and knowledge that the information given on this form is correct.

Student Name Date

SJC User Name