Updated 10/2/2019
WVC Student Information Update Form
WENATCHEE VALLEY COLLEGE
WENATCHEE VALLEY COLLEGE (OMAK)
1300 Fifth Street, Wenatchee WA 98801 116 West Apple Ave, Omak WA 98841
Phone: (509) 682-6806 Fax: (509) 682-6801 Phone: (509) 422-7800 Fax: (509) 422-7801
Email: Admissions@wvc.edu Email: Admissions@wvc.edu
When do you plan to return? Year__________
Summer (June - Aug.)
Fall (Sept.- Dec.) Winter (Jan.- March) Spring (April - June)
Name ______________________________________________________________
Social Security Number
Other Name(s) Used _________________________________________________
Date of Birth_______________
Mailing Address ___________________________________________
City _________________________ State _______ ZIP__________
Phone number __________________ E-mail Address (student/personal)____________________________
To comply with federal laws, we are required to ask for your Social =Security Number (SSN) or Individual Taxpayer Idencaon Number (ITIN). We will use your SSN/ITIN to report Hope Scholarship/Lifeme Learning
tax credit; to administer state/federal nancial aid; to verify enrollment, degree and academic transcript records; and to conduct instuonal research. If you do not submit your SSN/ITIN, you will not be denied access
to the college; however, you may be subject to civil penales (refer to Internal Revenue Service Treasury Regulaon 1.6050S-1(e)(4) for more informaon). Pursuant to state law (RCW 28B.10.042) and federal law
(Family Educaonal Rights and Privacy Act), the college will protect your SSN from unauthorized use and/or disclosure.
PROGRAM OF STUDY
_____________________________________________ PROGRAM OF STUDY (PROGRAMS LISTED ON OTHER SIDE)
RESIDENCY STATUS
1.Have you lived in the State of Washington for the past 12 consecutive months?
2. Do you have a drivers license or state ID?
If yes, in what state is your current drivers license issued in? State: _________
4.Are you active duty military or the spouse or dependent of an active duty military
member?
5.Are you a Washington National Guard member or the spouse of dependent of a
Washington National Guard member?
Yes | No
Wenatchee Valley College is commied to a policy of equal opportunity in employment and student enrollment. All programs are free from discriminaon and harassment against any person because of race, creed,
color, naonal or ethnic origin, sex, sexual orientaon, gender identy or expression, the presence of any sensory, mental, or physical disability, or the use of a service animal by a person with a disability, age, parental
status or families with children, marital status, religion, genec informaon, honorably discharged veteran or military status or any other prohibited basis per RCW 49.60.030, 040 and other federal and state laws and
regulaons, or parcipaon in the complaint process. The following persons have been designated to handle inquiries regarding the non-discriminaon policies and Title IX compliance for both the Wenatchee and Omak
campuses:
To report discriminaon or harassment: Title IX Coordinator, Wenatchi Hall 2322M, (509) 682-6445, tle9@wvc.edu.
To request disability accommodaons: Director of Student Access, Wenatchi Hall 2133, (509) 682-6854, TTY/TTD: dial 711, sas@wvc.edu.
Updated 10/2/2019
LIST ANY COLLEGES YOU ATTENDED OTHER THAN WVC.
NAME CITY STATE YEAR
List high school aended:
Did you graduate high school? Yes No GED? Yes No - If Yes, indicate year earned:_________
I understand that my request to change my current program may affect my financial aid eligibility and/
or award amount. I also understand this change may impact my time to degree completion. I certify
that my responses on this form are true.
Required applicants signature ______________________________________________________Date _____________
APPLICANTS SIGNATURE
Date received : ______________ Received by: ___________________________________________________________
OFFICE USE ONLY
Res Stat Leer Processed by FPS
Applied Baccalaureate Degrees
Nursing RN-BSN (32B)
Engineering Tech (64B)
Data Analytics (50D)
Academic Degrees
Associate in Arts & Sciences-DTA (007)
Associate in Science [Option 1] (061)
Associate in Science [Option 2] (062)
Associate in Business DTA/MRP (011)
Associate in Music DTA/MRP (MUS)
Associate in Nursing DTA/MRP (RNDT)
Academic Degrees- Non Transfer
Associate in General Studies (008)
Agriculture
Sustainable Agriculture [AAS-T] (105A)
Sustainable Agriculture (105)
Allied Health
Chemical Dependency Studies (437)
Emergency Medical Tech (364)
Medical Laboratory Technology (314)
Nursing Assistant (329)
Pharmacy Technician [AAS-T} (399)
Radiologic Technology (358)
Automotive
Automotive Technology (712)
Business Related
Accounting (505)
Business (502)
Business Computer Tech. [AAS-T] (547)
Gaming Operations Supervisor (241A)
Tribal Gaming Mgmt. (241)
Computer Technology
Computer Tech. -Network Admin (527)
Criminal Justice
Criminal Justice [AAS-T] (841B)
Criminal Justice (841)
Design
Graphic Design [AAS-T] (731)
Digital Design (504)
Early Childhood Education
Early Childhood Education [AAS-T] (402C)
Early Childhood (402)
Engineering Technology
Engineering Technology [AAS-T] (603)
Environmental Systems & Refrigeration
Environmental Systems/Refrigeration (703)
Fire Science
Fire Science (828)
Industrial Technology
Aerospace Electronics (780)
Industrial Electronics (657)
Machining (808)
Welding & Fabrication (814A)
Natural Resources
Natural Resources [AAS-T] (165B)
Outdoor Recreation Management
Outdoor Recreation Management [AAS-T] (128)
HS+ Washington State High School Diploma
HS+ High School Diploma