A.
Student’s Information
2020-2021
Cochise College
Number of Household Members and
Number in College
Student’s Last Name Student’s First Name Student’s M.I. Student’s C- Number
Student’s Street Address (include apt. no.) Student’s Date of Birth
City State Zip Code Student’s Email Address
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone Number
B. Family Information – List ALL the people in your household, including their names and ages. Also write in
the name of the college for any family member, excluding your parent(s), who will be attending college at
least half-time between July 1, 2020 and June 30, 2021, and will be enrolled in a degree, diploma, or
certificate program. If you need more space, attach a separate page.
Name of college
attending in 2020-2021
(At least Half‐time) DO
NOT INCLUDE PARENTS.
Yourself
DEPENDENT STUDENT
Yourself
INDEPENDENT STUDENT
Your parents(s) (including stepparent).
Your parents(s) other dependent children if (a)
your parent(s) will provide more than half of
their support from July 1, 2020 through June 30,
2021, or (b) the children would be required to
provide parental information when applying for
Federal Student Aid.
Your spouse (if you are married).
Your and/or your spouse’s children if you will
provide more than half of their support from
July 1, 2020 through June 30, 2021.
Other people only if they live in your household
and you provide more than half of their support
and will continue to provide more than half of
their support from July 1, 2020 through June 30,
2021.
Student Signature: Date:
Parent Signature: Date:
