Full Name ____________________________________________ CR ID# ________________________
APPLICATION
I, the undersigned, am applying for the California Nonresident Tuition Exemption at College of the
Redwoods and declare that the following apply to me.
1.) My current immigration status/Visa type is (check one and attach proper documentation):
Refugee
Special Immigrant Visa (i.e. SI1, SI2, SI3, SQ1, SQ2, SQ3)
2.) Upon entering the United States, (check one and fill in the date):
I settled in California on __________ /__________ /__________
Month Day Year
I settled outside of California, but moved to California on __________ /__________ /__________
Month Day Year
DECLARATION OF TRUE AND ACCURATE INFORMATION
I, the undersigned, declare under penalty of perjury that the information I have provided on this form is true and
accurate. I understand that this information will be used to determine my eligibility for the AB343 California
Nonresident Tuition Exemption pursuant to California Education Code 68075.6. I further understand that if any of
the above information is found to be false, I will be liable for payment of all nonresident tuition charges from which
I was exempted and may be subject to disciplinary action by the College.
Student’s Signature__________________________________________________ Date__________________________
OFFICIAL USE ONLY Approved Denied
Initials _______________ Date _____________
AB343 EXEMPTION EXPIRES ON:
Date: ______________ Term: _____________
AB343 NONRESIDENT TUITION
EXEMPTION REQUEST
AB 343 NONRESIDENT TUITION EXEMPTION PURSUANT TO CALIFORNIA EDUCATION CODE 68075.6
A student of the California Community Colleges who has a special immigrant visa that has been granted a status under
Section 1244 of Public Law 110-181 or under Public Law 109-163, or is a refugee admitted to the United States under Section
1157 of Title 8 of the United States Code, and who, upon entering the United States, settled in California, shall be exempt
from paying the nonresident tuition fee required by Section 76140 for the length of time he or she lives in this state up to the
minimum time necessary to become a resident.
If a student is granted an exemption from nonresident tuition, the exemption will expire one year from the date
the student settled in California upon entering the United States.
It is the student’s responsibility to submit a Residency Reclassification Form, along with documentation, before
or after the exemption expires in order to establish California Residency Status at College of the Redwoods.
Applying for this exemption does not alter the student’s responsibility to pay, by the campus deadline, any
nonresident tuition and associated fees that may be due before eligibility is determined.
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome