Residency Questionnaire Template
ADVERTISEMENT
1
2
3
4Residency Questionnaire
Texas Higher Education Coordinating Board Rule 21.731 requires each student to respond to the following questions for the purpose of determining the student’s eligibility for classification as a Texas
resident, and also must be completed by students appealing their residency determination, and by those whose changed circumstances merit consideration for reclassification.
Please follow instructions carefully. Most students are not required to complete all parts.
PART A: Student Basic Information
All students must complete this section.
Student ID Number ____ ____ ____ ____ ____ ____ ____
Date of Birth (MM) ____ ____ - (DD) ____ ____ - (YYYY) ____ ____ ____ ____
Use TCC Colleague ID
Name _________________________________________________ ______________________________ __________________________________
Last Name
First Name
Middle Name
Current Address: Street ___________________________________________________________________________
Apt. _________________
City _______________________________________________________ County ________________________________ Zip _______________
Relocation Address: Street _________________________________________________________________________
Apt. _________________
City _______________________________________________________ County ________________________________ Zip _______________
Phone: _______________________________________________ Email address ____________________________________________________
PART B: Previous Enrollment
To be completed by transfer 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
during a fall or spring term?
If you answered Yes, continue.
___Yes
If you answered No, skip to Part C .
___No
2. What Texas public institution did you last attend? Provide full name, not just initials.
Name of Texas public college or university last attended
City
3. Term/Year last attended ____ Fall
____ Spring
Year _____ _____ _____ _____
4. During that term/year, did you pay resident (in-state) or nonresident (out-of-state) tuition?
___ Resident (in-state) Continue to question 5.
___ Nonresident (out-of-state) Skip to part D.
___ Unknown Skip to part D.
5. If you paid in-state tuition at your last institution, was it because you were classified as a resident or because you were
a nonresident who received a waiver?
___ Resident .............................................................. Official transcript required, skip to Part I.
___ Nonresident with a waiver ........................... If you were classified as a nonresident.
___ Unknown............................................................ If you do not know, continue to Part C.
PART C: Residency Claim
1. Are you a resident of Texas? ___Yes
___No
If you answered Yes, continue to Part D.
If you answered No, complete the following question and skip to Part I.
Of what state or country are you a resident? ______________________________________________________________________________
If you are uncertain, continue to Part D.
PART D: Acquisition of High School Diploma or GED
1. Did/will you graduate from high school or complete a GED in Texas? ............................
___Yes
___No
Texas high school
Name
City
2. Did you live or will you have lived in Texas during all of the 36 months
leading up to high school graduation or completion of the GED? ...........................
___Yes ___No
1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Life