Residency Petition
Name COCC ID
Address City, State, Zip
Telephone E-Mail
I am current classified as:
□ In-State/Out-of-District □ Border State (CA, ID, NV, WA) □ Out-of-State
(circle one border state)
I am petitioning to be:
□ In-District □ In-State/Out-of-District □ Border State (CA, ID, NV, WA)
(circle one border state)
If petitioning for in-district status, check the
appropriate box; documentation MUST be
provided verifying your situation*:
□ I (or, if 23 or younger, my parent/legal
guardian) have lived in or own property in
the Central Oregon Community College
District since
__________________________ (date).
□ I am legally financially dependent upon an
in-district resident.
□ I graduated from a high school in the COCC
College District (note: you must be age 23
or younger as of the beginning of the term in
which you are applying).
□ My status with any of the Armed Forces
branch qualifies me for in-district residency.
□ Other (please explain on a separate sheet of
paper)
If petitioning for out-of-district/in-state
status or border state status, check the
appropriate box; documentation MUST be
provided verifying your situation*:
□ I (or, if 23 or younger, my parent/legal
guardian) have lived in or own property in
Oregon since
__________________________ (date).
□ I am legally financially dependent upon an
out-of-district /in-state resident.
□ I graduated from a high school in the state of
Oregon, but outside the COCC College
District (note: you must be age 23 or
younger as of the beginning of the term in
which you are applying).
□ My status with any of the Armed Forces
branch qualifies me for out-of-district/in-
state residency.
□ My status as a tribal member qualifies me
for out-of-district/in-state residency.
□ Other (please explain on a separate sheet of
paper)
Use additional sheets if necessary; attach all documentation and submit by the deadlines stated on reverse.
*Examples of supporting documentation (depending on situation): copy of rental/lease agreement, copy of state and
federal income tax returns, property tax statement, military papers, high school diploma, employment/payroll information
