Due by First Day of Classes to:
Office of Admissions
1100 North Avenue • Grand Junction, CO 81501-3122
970.248.1875 (phone) • 1.800.982.6372
residency@coloradomesa.edu
Residency Update Form 062916/lls
RESIDENCY UPDATE FORM
Student’s Full Legal Name: CMU ID#: 700-
Permanent Address (Street, City, State Zip):
Telephone Number: Email Address:
Age: Date of Birth: / / Effective Term: Fall Spring Summer of the Year 20
US Citizen: Yes No Asset/DACA
If not a US Citizen, is student a Permanent Resident of the US? Yes No
(Attach copy of Permanent Resident Card)
Are you claiming eligibility for In-State Tuition? Yes No
(If no, please sign, date and return form.)
Please complete all applicable items in one of the following sections as appropriate.
Provide STUDENT information if: • You will be 23 years of age or older by the first day of the semester, OR
• You are under 23 years of age and married (one year or longer), have a dependent child, or current/former
military service.
(If you are under 23 years of age, please attach a copy of your marriage certificate or child’s birth certificate)
Dates of continuous physical presence in Colorado: (MM/YY) From / To /
Dates of extended absence from Colorado (1 month or more duration) From / To /
Reason for absence:
Date of Purchase/Rental of Colorado Residence: (MM/YY) /
Date current Colorado Driver’s License/ ID issued: (MM/YY) / ID#
Date of Colorado voter registration: (MM/YY) /
Last 3 years of Colorado motor vehicle registration: 20 , 20 , 20
Dates of employment in Colorado: (MM/YY) From / To /
Current Employer: Work phone #:
Last 3 years Colorado state income taxes were filed: 20 , 20 , 20
Date of your marriage, if under 23 years of age: (MM/DD/YY) / /
Dates of military service, if applicable: (MM/YY) From / To /
Provide PARENT/LEGAL GUARDIAN information if: • Student will be under 23 years of age by the first day of the
semester and is unmarried OR • Student will be under 23 years of age and married for less than one year.
(If Legal Guardian, please attach copy of court order appointing “Legal Guardianship”)
Dates of continuous physical presence in Colorado: (MM/YY) From / To /
Dates of extended absence from Colorado (1 month or more duration) From / To /
Reason for absence:
Date of Purchase/Rental of CO Residence: (MM/YY) /
Date current Colorado Driver’s License/ ID issued: (MM/YY) / ID#
Date of Colorado voter registration: (MM/YY) /
Last 3 years of Colorado motor vehicle registration: 20 , 20 , 20
Dates of employment in Colorado: (MM/YY) From / To /
Current Employer: Work phone #:
Last 3 years Colorado state income taxes were filed: 20 , 20 , 20
Dates of military service, if applicable: (MM/YY) From / To /
Dependents of non-resident, active duty military personnel stationed in Colorado may request a tuition adjustment to in-state status
for tuition purposes.
Residency is determined based upon the Colorado Revised Statutes §23-7-101, et. seq. Making a false, fictitious or fraudulent
statement or representation in connection with this application is punishable under criminal laws of Colorado as perjury in the second
degree under CO Revised Statutes 18-8-503, and constitutes a separate criminal offense each time a public benefit is fraudulently
received because of this statement.
SIGNATURE: DATE:
Person completing form (if not student) Relationship to Student:
OFFICE USE ONLY BELOW THIS LINE
Approved Denied Date Student Record Updated/By
