Fillable NEW MEXICO RESIDENT TUITION WAIVER PROGRAM (Northland Pioneer College)

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NEW MEXICO RESIDENT TUITION WAIVER PROGRAM (Northland Pioneer College)

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NEW MEXICO RESIDENT TUITION WAIVER PROGRAM
Northland Pioneer College and Western New Mexico University, Silver City, New Mexico, have
established an out-of-state tuition waiver agreement. New Mexico residents who attend Northland Pioneer
College may be assessed Arizona Resident Tuition. Likewise, Arizona residents attending Western New
Mexico University may qualify for New Mexico Resident Tuition. There are a limited number of waivers
for each location. Out-of-state tuition may be waived for students taking 3 or more credits.
In order to apply for the New Mexico Student Tuition Waiver at Northland Pioneer College, an application
for a New Mexico Resident Tuition Waiver must be sent by the applicant to:
Records/Registration Ofce
Northland Pioneer College
P.O. Box 610
Holbrook, AZ 86025
(928) 524-7459 or 1-800-266-7845, ext. 7459
The following regulations apply:
1. Legal residency in New Mexico.
2. Acceptance to Northland Pioneer College.
3. Must register for 3 or more credits at Northland Pioneer College.
4. Maintenance of a minimum 2.0 cumulative grade point average or above.
5. Re-application required each semester, prior to August 15 for Fall semester, and December 1
for Spring semester.
As the number of New Mexico Resident Tuition Waivers available is limited, the following guidelines
will be used to determine awarding of waivers (listed in order of priority).
1. Returning Northland Pioneer College students currently receiving tuition waivers.
2. All other admitted students based upon the date the application is received by Northland Pioneer
College.
3. Students at the time of registration if any New Mexico Resident Tuition Waivers are still
available.
If you have any questions regarding the New Mexico Resident Tuition Waiver program please contact
the Records/Registration Ofce at Northland Pioneer College, 1-800-266-7845, ext. 7459.
Name______________________________________________ Date _________________________
Mailing Address ___________________________________________________________________
City_______________________________ State________________ ZIP ______________________
Phone ________________________________ Student ID Number __________________________
Date Moved to New Mexico _________________________________________________________
Physical Address __________________________________________________________________
_________________________________________________________________________________
Program of Study_____________________________ Degree Intent _________________________
Semester for Waiver___________________________
______ I will register for 3 or more credits this semester
I have completed an APPLICATION FORM. I have read the regulations which apply to the New
Mexico Resident Tuition Waiver Program and I understand that failure to comply with these regulations
will result in a loss of tuition waiver the following semester.
I authorize Northland Pioneer College to release to the State of New Mexico, or an agent thereof, the
following information as it pertains to my enrollment in the New Mexico Tuition Waiver Program: Social
Security Number, student identication number, name, permanent address, credits enrolled by term, credits
completed by term, GPA, program of study and degree intent.
By submitting this form, I certify that the
information I provided is accurate. I have not given false or misleading information, I understand that
if it is found to be otherwise, it is sufcient cause for rejection or dismissal.
Signature___________________________________________ Date_________________________
APPROVED:
Signature______________________________________ Date__________ Waiver Sent_________
APPLICATION
NEW MEXICO RESIDENT TUITION WAIVER PROGRAM
MPR-EcR 3/19 • /Marketing/Forms/Rec & Reg/NMTuitionWaiver-Master
PUBLIC NOTICE OF NONDISCRIMINATION: Northland Pioneer College does not discriminate on the basis of race, color, national origin, veteran status,religion, marital status, gender,
age or disability in admission or access to, or treatment or employment in its educational programs or activities. District grievance procedures will be followed for compliance with Title IX and Section
504 requirements. The Afrmative Action Compliance Ofcer is the Director of Human Resources, 2251 E. Navajo Blvd., Holbrook, Arizona 86025, (800) 266-7845. The Section 504 Compliance
Ofcer is the Coordinator of Disability Resource and Access, 1001 W. Deuce of Clubs, Show Low, Arizona 85901, (800) 266-7845. The lack of English language skills will not be a barrier to admis-
sion and participation in vocational education programs. Revised 9-12-14
as mm/dd/yyyy
as mm/dd/yyyy
as mm/dd/yyyy
as mm/dd/yyyy as mm/dd/yyyy
NM
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NEW MEXICO RESIDENT TUITION WAIVER PROGRAM (Northland Pioneer College)

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Completed 2 September 2020

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