MSU Denver Office of Admissions
Student Success Building | Counter #1
Campus Box 16 PO Box 173362
Fax Number: 720-778-5794
Phone Number: 303-556-3058
msudenver.edu/admissions | firstname.lastname@example.org
In-State Correction Form
Page 1 of 2
DO NOT COMPLETE THIS FORM IF:
• You previously attended MSU Denver and paid out-of-state tuition within the last 3 semesters. Please
complete the Petition for In-State Tuition.
• You are an individual who was emancipated prior to turning 23. Please complete the Petition for In-State Tuition
and the Emancipation Determination.
• You are a resident of AK, AZ, HI, ID, MT, NV, NM, OR, SD, UT, WA, WY or the Commonwealth of the Northern
Mariana Island and intent to enroll under the Western Undergraduate Exchange Program (WUE). Please
complete the WUE New Student Participation Form.
• You are Active Duty Military. Please complete the Military Certification for Tuition Classification.
• You are a U.S. Armed Forces Veteran. Please complete the U.S. Armed Forces Veteran In-State Tuition
I hereby certify that, to the best of my knowledge, the information provided on this form is true and complete. I understand that if falsified
information or supporting documentation is provided, any resulting in-state classification action based upon this document becomes
voided and will be retroactively nullified.
Are you a U.S. Citizen? ___ Yes ___No
If you are not a U.S. Citizen, what is your
Resident __Asylee / Refugee __Adjustment Applicant __DACA/Undocumented __Other:_________
If you did not submit documentation of your status with your application, please attach a copy to this form.
1. Were you enrolled in a Colorado public or private high school for the three years immediately preceding
graduation? __Yes __No
2. Were you enrolled in a Colorado public or private high school for the three years immediately preceding your
GED exam? __Yes __No
If you answered ‘Yes’ to question 1 OR 2, when was the Colorado HS Diploma / GED received? _____/ _____/ _____
Please answer the following questions for your parent or legal guardian if you are under 23 years old and not
married for at least one year.
___Self ___Parent ___
Guardian (Legal Documentation Required)
1. Dates of continuous residence in Colorado: From _____/_____/_____ To _____/_____/_____
2. List any dates of extended absences from Colorado in the last year and provide explanation:
From _____/_____/_____ To _____/_____/_____ Reason: ______________________________________
3. Last two years Colorado income taxes have been filed :________ , _______
4. Date current Colorado driver’s license or ID was issued:_____/_____/_____
5. Was Colorado driver’s license or ID renewed: Yes No
6. Last two years of Colorado motor vehicle registration: ________ , _________
7. Date of Colorado voter registration: _____/_____/_____
8. Rent or own a primary residence in Colorado: Yes No
9. Source of income or support :
From _____/_____/_____ To _____/_____/_____
loyer or Income Source: _______________________________ State: __________________________
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