Puerto Rico Residents
Earthquake Displacement In-State Tuition Form
Year:
Term: Fall
Spring
Summer
Campus:
Hialeah
Homestead
Kendall Medical North Padrón
West Wolfson Meek
This form is for students who have been displaced by the Earthquakes in Puerto Rico. Temporary in-state
tuition will be granted to students who meet this criteria. Students will have 6 months to provide the College
with the required transcripts from any high school/college institution(s) they have attended.
Name:
Last
First
Middle
Date of Birth:
Phone:
Address:
City:
Name of Post Secondary Institution in Puerto Rico:
Address:
City:
Program of Study:
Approved by:
Director of Admissions and Registration
Signature
Date
Created 1/13/2020
For Office Use Only