Revised 11/4/19
APPLICATION FOR ADMISSION
Big Bend Community College
7662 Chanute St NE - Moses Lake, WA 98837
509-793-2061 - admissions@bigbend.edu
STEPS TO APPLY FOR ADMISSION
Fill out the admission application
completely and submit it to BBCC.
If you are transferring credits from another college, you should have an official copy of all transcripts sent directly to BBCC.
Your application will be processed for the quarter and year indicated on your application. IF YOU DO NOT ENROLL FOR THAT
QUARTER, NOTIFY THE ADMISSIONS OFFICE if you wish to be admitted for a future quarter.
You must repeat the above admissions procedures if you apply for admission and do not register for classes within one year.
Your Social Security number is confidential and the College will protect it from unauthorized use, it is not used as your student ID
number. In compliance with state/federal requirements, disclosure may be authorized for the purposes of financial aid, Hope & Lifetime
Learning tax credits, academic transcript, or accountability research.
PLEASE PRINT CAREFULLYSHADED AREAS ARE FOR OFFICE USE ONLY.
What do you plan to study at BBCC?
Do you plan to transfer to a 4 year college? Yes No
Social Security #
Quarter you plan to start: Summer Fall Winter Spring 20____
Have you attended BBCC
before?
Yes No
Sex:
Female
Male
Birth date: Month/Day/Year
Cell phone
Home phone
Legal Name (Last, First, Middle)
Mailing Address
Home Address if different from Mailing Address
City, State Zip code
Name
Telephone
Email Address
What race do you consider yourself to be?
Commitment to Diversity
Big Bend Community College
offers a variety of academic,
financial, cultural, and
personal support services to
interested students. We are
committed to enrolling a
diverse student body.
White/Caucasian (800)
Alaskan Native or
Na
tive American (597)
African American
(870)
Chinese (605)
Vietnamese (619)
Japanese (611)
Korean (612)
Other Asian or Pacific Islander
(621)
Filipino (608)
Other Race (specify) (622)
________________________
Hispanic (717)
Mexican, Mexican-American
(722)
Other Spanish/Latino (for
example: El Salvadorian,
Guatemalan, etc.)
_____________________
U.S. Citizen or Legal Permanent Resident?
Citizen Legal Permanent Resident (Please provide a copy of your card)
If not U.S. citizen or legal permanent resident, please provide information to allow us to determine your Washington residency status.
Temporary resident - Attach copy of both sides of alien card.
Refugee/parolee or conditional entrant - Attach copy of both sides of I 94.
International student (with or requesting an F visa)
Visitor
Other __________________________________________________________________________________________
Revised 11/4/19
Washington State Residency Status
Washington’s residency laws
ask that students be defined as
either financially independent
of parents or financially
dependent upon parents.
For
financially dependent
students to be classified as a
resident, parent(s) or legal
guardian(s) must claim the
student as a dependent and be
a resident of the state for at
least one year before the
quarter for which the student
wishes to enroll.
Students who are financially
independent must establish a
permanent residence in
Washington for at least 12
consecutive months before the
quarter of application,
establish all ties with
Washington upon moving here
(obtain Washington driver’s
license, register to vote,
license vehicle), be financially
independent of parents for
current and previous year, and
cannot be claimed as a
dependent.
1. Have you lived in the state of Washington continuously for the past twelve
months?
2. How long have you lived continuously in the state of Washington?
3. For the last calendar year, did your mother, father, or legal guardian claim you
as a dependent on their federal income tax return?
4. For the current calendar year, will your mother, father, or legal guardian claim
you as a dependent on their federal income tax return? If yes, please answer
questions 5 and 6. If no, skip to question 7.
5. If you were claimed, or you will be claimed, as a dependent on a federal
income tax return, has your mother, father, or legal guardian lived in the state
of Washington continuously for the past twelve months?
6. How long has your mother, father, or legal guardian lived continuously in the
state of Washington?
7. Will you be receiving financial assistance from a non-federal agency other
than the State of Washington (for example, Alaska student loan or tribal
funds)? If yes, explain:____________________________________________
8. Are you current or former active duty military?
Current and former active duty military, their spouses and dependents may qualify for
Washington residency and/or educational benefits. Please contact our Veteran’s
Coordinator in the Student Services Office in the 1400 Building, or call 509-793-2452
for more information.
Y
es No
____Yea
rs ____Months
Yes
No
Yes No
Yes
No
____Yea
rs ____Months
Y
es No
Yes No
Previous Education
Have official copies of college transcripts sent to Big Bend Community College.
Name and location of last high school attended
1. Date you graduated or will graduate Month_____ Year_____
2. If you did not graduate, indicate highest grade completed____
3. Have you successfully completed the GED test?
Yes No If yes, what year ______ Where?________________
H.S code
Most recent college, vocational/technical school attended
City and State
When attended
Degree
Yes
No
College code
Name of other college(s), vocational/technical school(s)
attended
City and State
When attended
Degree
Yes
No
College code
Name of other college(s), vocational/technical school(s)
attended
City and State
When attended
Degree
Yes
No
College code
Name of other college(s), vocational/technical school(s)
attended
City and State
When attended
Degree
Yes
No
College code
Student Status
Please check this box if you have been in Washington State foster care for at least one year since your 16
th
birthday.
Has either of your parents/guardians received a bachelor’s degree (4 year degree)? Yes No
Applicant Signature____________________________________________________ Today’s Date_______________________________
Big Bend Community College does not discriminate on the basis of race, color, national origin, sex, gender, disability, age, or any other legally protected status in its programs or
activities. The following person(s) have been designated to handle inquiries regarding the non-discrimination policies. Kim Garza, Title IX Coordinator, Building 1400, Office 1449
at (509) 793-2010 or kimg@bigbend.edu or Lora Lyn Allen, Coordinator of Disability Services, Building 1400, Office 1472 at (509) 793-2027 or loraa@bigbend.edu.
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