CALIFORNIA NONRESIDENT TUITION EXEMPTION REQUEST
(Education Code section 68130.5, commonly known as AB 540 Effective Jan. 1, 2018)
Full Name ___________________________________________________ CR ID# _____________________________________
INSTRUCTIONS: Complete and sign this form to request exemption from nonresident tuition charged to nonresident students. Once determined to be
eligible, you will continue to receive the exemption as long as you fulfill eligibility requirements or until the College no longer offers this exemption.
Applying for this exemption does not alter your responsibility to pay, by the campus deadline, any nonresident tuition and associated fees that may be
due before your eligibility is determined.
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.) CHECK ONE BOX ONLY:
I have a current nonimmigrant visa (not including a T and U visa) as defined by federal law.
Nonimmigrants have been admitted to the U.S. on a temporary visa and include, but are not limited to, foreign students (holding F visas) and
exchange visitors (holding J visas).
I have a current nonimmigrant visa and have been granted T or U visa status as defined by federal law.
I do NOT have a current nonimmigrant visa as defined by federal law.
This includes, among others, U.S. citizens, permanent residents, DACA recipients, and individuals without current or valid immigration status.
2.) SELECT ALL ITEMS THAT APPLY TO YOU FROM EACH COLUMN:
COLUMN A
COLUMN B
I have 3 years of attendance at a California high school. I have graduated or will graduate (before the first term of enrollment at
the CCC) with a California high school diploma or the equivalent (i.e.,
California-issued GED, CHSPE).
I have 3 or more years of high school coursework and 3 years of
attendance in California elementary schools, California secondary
schools, or a combination of California elementary and Secondary
schools.
I completed or will complete (before the first term of enrollment at the
CCC) an associates degree from a California Community College.
I attended or attained credits at a combination of California high
school, California adult school
, and/or California Community College for
the equivalent of 3 years or more.*
I completed or will complete (before the first term of enrollment at the
CCC) the minimum requirements at a California Community College for
transfer to the California State University.
*A year’s equivalence at a California community college is either a minimum of 24 semester units of credit or 36 quarter units. Only two (2) years of full-time attendance in credit
courses at a California Community College will count toward the three (3) or more years of attendance. For noncredit courses, a years attendance is a minimum of 420 class hours
per year (a semester is equivalent to a minimum of 210 hours and a quarter is equivalent to a minimum of 140 hours). Full-time at a California adult school is a minimum of 420 hours
of attendance for each school year.
3.) PLEASE PROVIDE INFORMATION ON THE SCHOOLS YOU ATTENDED AND REFERENCED ABOVE,
INCLUDING THE DATES YOU ATTENDED AND THE NUMBER OF CREDITS OR HOURS OBTAINED:
Name of CA School
Type of School
(high school, adult school or community college)
City
From
(Month/Year)
To
(Month/Year)
Number of
Credits or Hours
Applicants must submit, as part of this form, official transcripts/attendance records that validate any of the information above as requested by the College.
AFFIDAVIT: By signing this document below, I hereby state that if I am a non-citizen without a current or valid immigration status, I have filed an
application to legalize my immigration status or will file an application as soon as I am eligible to do so.
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 California Nonresident Tuition Exemption.
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 (reason) ___________________________________ Initials ______________ Date ______________ ASPR Email ST-ITR Excel BILL
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