Contact Information Telephone: (409) Website:

APPLICATION FOR ADMISSION

ADMISSIONS REQUIREMENTS AND INFORMATION FOR GALVESTON COLLEGE

Admission Policies

Galveston College (GC) is a center for educational opportunity which exists to enhance the quality of life, learning and livelihood of individuals by fostering their personal growth in a student-centered environment. Because Galveston College believes that all individuals have the potential and the need for learning throughout life, the College is committed to an open admissions policy. Open admission does not imply admissions to all programs because some courses require special skills, aptitudes, training, and prerequisite for success. An applicant may obtain additional information concerning admissions from the Office of Admissions.

General Admissions Procedures

1. Complete the application for Admissions, student information sheet and core residency; mail or submit completed forms to the Office of Admissions. 2. Request appropriate educational transcripts and have them sent to Galveston College Office of Admissions; 4015 Avenue Q; Galveston, Texas 77550. 4. Complete admissions testing if needed.

5. Meet with Galveston College Counselor to go over test results, degree plan, and course selection prior to registration.

6. Admission information and forms can also be found online at www.gc.edu under the Admissions and Records link.

Testing and Assessment

The Texas Success Initiative (TSI) was passed by the Texas State Legislature in 2003 to improve the success of students attending public colleges and universities in Texas. The TSI requires the assessment of academic skills of each entering student to determine the student’s readiness to enroll in college-level academic coursework. The Texas Higher Education Assessment (THEA) is a state-wide administered test that assesses the academic skills of students. Galveston College administers the COMPASS test as an alternative to THEA to assess entering student’s academic skills. Other tests that are considered THEA alternative are ASSET and ACCUPLACER. The COMPASS Test is given on a daily basis in the Testing Center located in the Learning Resource Center (LRC). Students should test as early as possible so that scores are available for Counselors and Advisors to review prior to Registration. Test scores determine if students are required to enroll in classes designed to enhance skill levels before they are allowed to enroll in college-level courses.

(*Exemptions can be found on the Texas Higher Education Coordinating Board website at http://www.thecb.state.tx.us/OS/ Success Initiatives/DevEd/, Exempt students may still need Placement to determine academic skill levels)

First Time Students

A completed application and official test scores or official exemption documentation is required by all first time students. Additional documents required for admissions varies based on a students basis of admissions.

•High School Graduates require:

A final Official high school transcript showing graduation date and final GPA •GED Graduates require:

An Official GED Certificate with scores and completion date •Home School or Non Accredited High School Graduate require:

A completed copy of the student’s transcript signed and notarized by the principal or head of instruction, showing the date of graduation.

Ability to Benefit Form signed by the Dean of Enrollment Services •High School Dual Credit or Early Admissions require:

Application for Dual/Concurrent Enrollment Form (must be signed by Parent and High School Principal or Counselor)

An Official In-Progress High School transcript with TAKS scores. Placement Test Waiver Form (if eligible)

Students may be eligible for a Waiver from the Placement Test if they have a A minimum score of 2200 and an Essay score of 3 or higher on the English/ Language Arts section and/or a minimum of 2200 on the Math section.

Students who are not eligible for a Waiver will be required to take all parts of the Placement Test (Compass).

•Non-High School or GED require:

Special Approval from the Dean of Enrollment Services

Transfer Students

A completed application and official test scores or official exemption documentation is required by all students transferring from a Regional Accredited College or University. Additional documents required for admissions varies based on hours completed. •Students transferring with less than 15 hours require:

Official High School Transcript or GED Certificate Official Transcript from all colleges attended

•Students transferring with more than 15 hours require: Official Transcript from all colleges attended

Contact Information

Telephone: (409) 944-1450 Website: www.gc.edu

Returning Student

Students who have not attended Galveston College continuously, not including summer semesters, should submit a readmission application (short form) if their last enrollment has not exceeded two years. Students who have not been enrolled for more than two years must complete the application for admission (long form). Returning students should request official transcripts from all schools attended since their last enrollment at Galveston College.

International Students

To be considered for admissions to GC, international students must submit the following:

•

Complete application for Admissions, student information sheet and core residency forms.

•Provide all official high school and college transcripts. All transcripts must be officially translated and evaluated by an approved agency

•Submit a Statement of Financial Support that must be signed by a parent, or sponsor.

•Submit supporting evidence of income and resources as appropriate.

•Provide Test of English as a Foreign Language (TOEFL). A minimum score of 500 is required. The school code for GC is 6255.

•Provide evidence of U.S. medical insurance coverage, at time of registration. Additional documents required for International students transferring from a U.S. college or university

•Official transcript from each college or university attended •Foreign student advisors report and a copy of current 1-20 •Copy of passport and I-94 card

The Application Deadlines for International students are: Fall – July 14 Spring - Oct 30

Counseling

GC Counselors are available to assist students throughout the year.

GC also has program Advisors for the Allied Health and the Nursing Departments. 1. Each new applicant should have an individual or group meeting with a Galveston College counselor prior to enrollment.

2. Transcripts and other pertinent information will be reviewed by the counselor. 3. All specific admissions information will be reviewed with applicants by Galveston College counselor

.

4. Additional Information can be found online at www.gc.edu under the Student Services link.

Orientation

All new students will be required to attend an Orientation session prior to the beginning of each semester. Orientation is offered to familiarize the new student with college policies and procedures as well as acquaint the student with the college campus and the different departments

.

Contact the counseling staff for additional information at (409) 944-1220.

Financial Aid and Scholarships

If you need financial assistance with college expenses, plan to visit the Financial Aid Office or call (409) 944-1235. You may apply for funds from a variety of sources including grants, scholarships, loans and work-study. Information about the application process and availability of funds is available form the Financial Aid Office. The application for Federal Aid can be found at www.fafsa.ed.gov.

The Galveston College Catalog contains information about financial assistance including scholarships from private donors and the College. Eligibility criteria vary among the different programs.

Universal Access

The Galveston College Foundation funds a program called Universal Access that promises free tuition and fees to every local GED, High School and Home School graduates that lives in the Galveston Community College District. The program is available for eligible applicants who graduated after May 2001 and file the required FAFSA. Funds are provided by sources from Pell Grants, Texas Grants or a local community Endowment Fund. Students should visit the Financial Aid Office for complete eligibility requirements.

Transfer of Courses

Galveston College is accredited by the Southern Association of Colleges and Schools Commission on Colleges, and college parallel courses are generally transferable to senior institutions. The counseling center maintains transfer information for most colleges in Texas. The final decision on transferability of a course however; is made by the senior institutions and students are encouraged to check with the Office of Admissions of the school to which they will transfer.

Mailing Address

:

Galveston College Office of Admissions

For Office Use Only 1 In State 3 Out-of-State 4 International 5 Waiver Notes:

Admissions Application

INSTRUCTIONS: Complete all items on this application. Print clearly all entries except signature. Codes needed to complete this application may be found at the end of the application. Proof of Texas Success Initiative status is required prior to registration. An incomplete application can hinder or prohibit your enrollment at Galveston College.

Check one:

First time college student

Returning Student

Transfer Student

High School Student

I plan to enroll: _______Year

Fall

Spring

Summer I

Summer 2

Educational Intent:

1. Earn a Degree (2 year)

4.Courses to improve current job skills/new employment

(Check one that applies)

2. Earn a Certificate (less than 2 years)

5. Not seeking a degree/certificate

3. Earn credits for transfer

6.Undecided at this time

PART A. Student Demographic Information

1.

Social Security Numbe

r

: ___________ - ______ - _____________

2

. Gender:

Male

Female

3.

Full, Legal Name: _____________________________________________________________________________________________

(Last/Family)

(First) (Middle) (Suffix: Jr, etc.)

_____________________________________________________________________________________________

Other Names Which May Appear on Academic Records

4.

Date of Birth (Required): (Month/Day/Year) ______/_______/______

5.

Current Residential Addresss:_____________________________________________________________Apt# ___________________

City__________________________________ State_________________________Zip________________ Country__________________

6

. How long have you lived at your current address? ________Years ___________Months

If less than 12 months, give address (es):

Street _________________________________City__________________State_____________________From ____/____ to _____/_____

Street _________________________________City__________________State_____________________From ____/____ to _____/_____

Mailing Address:____________________________City______________________State__________Zip_________Country___________

7

. Home Phone:

(_____) ______-__________ Cell Phone: (_____) _______- ___________ Work Phone: (_____) ______-___________

8

. Email address_____________________________________________________

9

. Emergency Contact: (Name) ________________________________________________

Phone: (_______) _______-______________

10.

Place of Birth: ____________________________________________________________________________________

(City) (State) (Country)

11.

Are you a U.S. citizen?

Yes

No

If “

No

,” of what country are you a citizen? _________________________________

If you are not a citizen, do you hold Permanent Residence status (valid I-551) for the U.S.?

Yes

No

If “Yes,” date permanent resident card

*

issued: _____/_____/_______ Alien Number: ______________

If you are not a U.S. citizen or permanent resident, do you have an application for permanent residence (form I-485) pending with the

U. S. Citizenship and Immigration Services (USCIS)?

*

Yes

No

*Submit a copy with your application

Questions 12 – 14 are Optional: The information will be used for federal and/or state law reporting purposes only.

12.

Marital Status:

Single

Married

Separated

Divorced

Widow/Widower

13

. Ethnic Background:

Please indicate which of the following group(s) best describes your ethnic background.

1. White, Non-Hispanic

3.Hispanic

5.American Indian or Alaskan Native

2. Black, Non-Hispanic

4.Asian or Pacific Islander

6. Alien

14.

Please indicate the highest level of your parents’ or court-appointed legal guardian’s educational background:

Father/Legal Guardian:

No high school

Some high school

High school diploma or GED

Some College

Bachelor’s Degree

Graduate/Professional Degree

Mother/Legal Guardian:

No high school

Some high school

High school diploma or GED

Some College

Bachelor’s Degree

Graduate/Professional Degree

It is the policy of Galveston College to provide equal opportunities without regard to age, race, color, religion, national origin, sex, disability or veteran status. This policy extends to employment, admission, and all programs and activities supported by Galveston College. Inquiries concerning equal opportunities may be directed to the Director of Personnel Services and

Educational Information

15

. Major/Program Choice:

(listed at the end of the application)

16

. High School Attended: ________________________________________________________________________________________

(Complete Name of High School) (City) (State)

Are you currently in high school?

Yes

No Date of anticipated graduation ______Month, ______Year

Did you graduate from high school?

Yes

No If yes, date ______Month, ______Year

Did you graduate from a home-schooled program:

Yes

No If yes, date ______Month, ______Year

If you did not graduate, did you receive a GED?

Yes

No If yes, date ______Month, ______Year _______________State

17

. High School Code______________ (Codes listed at the end of the application)

18.

Did you take a Tech Prep course or courses in high school for college credit?

Yes

No

19

. Indicate on what basis you are seeking admission:

High

School

Graduate

College Transfer – Degree-seeking

College Transfer – Not Degree-seeking

Readmission from prior semester

Transient – Seeking a degree elsewhere

GED

Home Schooled/High School Graduate

Individual Approval (no high school diploma or GED)

Dual Credit (receiving both high school and college credit)

High School Early Admission (college credit only)

Non-Degree Seeking Student

20

. List ALL colleges and universities you have attended or are attending, including college-level correspondence study and dual credit. Failure to list all in-

stitutions will be considered an intentional omission and may lead to forced withdrawal. Transcripts

should

be on file

prior

to first-time enrollment, but all

required transcripts

must

be received before the next registration period or enrollment and records will be

blocked

. Transcripts should be sent from institution

to institution. Hand-carried transcripts will be considered official only if received in an unopened sealed envelope.

(Note: If more space is needed attach an

additional page and include the information asked for below.)

College Name

Location

(City, State, Country)

Dates Attended

From To

Hours/Degree

Earned

Are you now or (if currently enrolled) do you expect to be on academic probation or suspension from the most recent school attended?

Probation

Yes

No If yes, which school?

Suspension

Yes

No If yes, which school?

If suspended, give date eligible to return:

21.

Total semester hours completed at all colleges/universities:

1. 0-29 SEM. HRS – Freshman

4. Associate Degree

2. 30-59 SEM. HRS – Sophomore

5. Baccalaureate or Above

3. 60+ SEM. HRS /No Degree – Unclassified

22

. What is your Texas Success Initiative status (TSI)?

TSI exempt based on (first time determination must be done by a counselor/Advisor):

ACT scores

SAT scores

TAKS scores

Military service

Associate Degree

Bachelor Degree

Private/Out-State Transfer w/college level coursework

Test(s) taken:

TASP/THEA

ASSET

ACCUPLACER

MAPS

COMPASS

CERTIFICATION OF INFORMATION (Read and mark each section)

Notification of Rights under the Family Educational Rights and Privacy Act (FERPA): Information collected about you through this application may be held by any Institution of higher education to which you apply. With few exceptions, you are entitled on your request to be informed about the collected information. Under Sections 52.021 and 552.023 of the Texas Government Code, you are entitled to receive and review the information. Under Section 559.004 of the Texas Government Code, you are entitled to correct information held by an institution that is incorrect. You may correct information held by any institution to which you apply by contacting your in- stitution. The information that is collected about you will be retained and maintained as required by Texas records retention laws (Section 441.180 et seq. of the Texas Government Code) and rules. Different types of information are kept for different periods of time.

If my application is accepted, I agree to abide by the policies, rules and regulations at any college to which I am admitted. I certify that the information on this application Is complete and correct and I understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment and/or appropriate disciplinary action. I understand that officials of my college will use the information submitted on this form to determine my status for residency eligibility. I authorize the college to verify the information I have provided. I also authorize the college to electronically access my records regarding the Texas Success Initiative. I agree to notify the proper officials of the institution of any changes in the information provided.

Bacterial Meningitis Confirmation – I hereby acknowledge that detailed information about the symptoms and treatment of Bacterial Meningitis is available to me on the Galveston College website as required by the Texas Education Code, Chapter 51, Section 51.9191.

Signature: ________________________________________________________________________ Date: ___________________

Financial Aid Information

You must apply for financial aid separately. You can apply on-line at www.fafsa.ed.gov. Contact the institution’s financial aid office directly

for more information.

HIGH SCHOOL CODES

Code Major

Code

Major

Code Major

Code

Major

01

Ball High (Central) 06

Hitchcock

11

Houston

15

GED

02

O’Connell

(Kirwin/Ursuline)

07

Santa Fe 12

Others in Texas 16

Non-High School Graduate

03

La Marque 08

High Island 13

Out-of-State 17

Heritage Academy

04

Texas City 09

Friendswood

14

Out-of-Country 18

Home Schooled

05

Dickinson

10

Clear Creek (Lake)

ASSOCIATE OF APPLIED SCIENCE DEGREE PROGRAMS (AAS

)

An Associate of Applied Science Degree is awarded to students who have successfully completed an approved curriculum for

a two year occupational program and is usually sufficient for entrance into an occupational field. Majors with an “*” require a

separate application and additional admissions requirements prior to acceptance into the program.

Code Major

Code Major

Code Major

5821

Accounting

7104

Emergency Medical Services

5814

Office Administration

5200

Biomedical Technology 5675

Mgmt Dev Hotel, Restaurant and

Tourism Mgmt.

Petrochemical Process Technology

6024

Microcomputer Applications & Networki 5624

General Management Option

8037

Nuclear Medicine Technology*

5505

Criminal Justice

1299

Nursing*

8045

Radiation Therapy Technology*

5825

Medical Secretary

1297

LVN to ADN Transition*

8032

Radiography*

5656

Culinary Arts/Hospitality Mgmt

1295

EMT-P to ADN Transition*

CERTIFICATE PROGRAMS

A Certificate program is an intensive program of study requiring less than 60 credit hours for completion. These programs are

normally designed to provide short-term training necessary to develop entry-level job skills without requiring completion of an

Associate Degree. Credit may be awarded toward a respective degree at Galveston College on the vast majority of work taken

in the certificate program. Certificates with an “*” require a separate application and additional admissions requirements prior to

acceptance into the program.

Code Major

Code Major

Code Major

5820

Para-Professional Accounting 7100

Emergency Med Services: Basic 5006

Office

Assistant

6025 Microcomputer

Networking

7101 Emergency Med Services: Intermediate

5111

Medical Office Assistant

6022

Microcomputer Applications

7103

Emergency Med Services: Paramedic

5110

Phlebotomy Technology

5504

Criminal Justice

5676

Hotel, Restaurant and Tourism Mgmt

5300

Breast Imaging/Mammography*

5506

Law Enforcement Academy

5677

Sales, Conference Services & Catering

5291

Computerized Tomography*

5655

Culinary /Hospitality Management

5623

General Management

5293

Magnetic Resonance Imaging*

6228

Culinary Arts

7821

Vocational Nursing*

8047

Radiation Therapy Technology*

6229

Culinary Arts/Baking and Pastry

5007

Administrative Professional

7820

Surgical Technology*

ASSOCIATE OF ARTS DEGREE PROGRAMS (AA

)

An associate of arts degree is a program of study requiring at least 60 credit hours for completion. This program normally

satisfies the requirements for the first two years of a four-year degree, which may be completed by the student upon transfer to

a university. Programs of study for the Associate of Arts degree parallel the first two years required for Bachelor of Arts and

Bachelor of Science degrees at many senior colleges and universities. Contact the senior college or university of choice for

transferability of courses and admission requirements.

Code

Major

1235 General

Studies

FOR MORE INFORMATION

Information regarding admission requirements for Galveston College is available on-line at

www.gc.edu

or contact the Office of

Admissions at (409) 944-1230.

CORE RESIDENCY QUESTIONS

Texas Higher Education coordinating Board rule 21.731 requires each student applying to enroll at an institution to respond to the following set of core residency questions for the purpose of determining the student’s eligibility for classification as a Texas resident. All new students or students returning to school after being out at least twelve months are required to answer the questions below.

PART A. Student Basic Information

__________________________________________________________

Last Name First Name MI

_____________ -___________-________ ______/_______/_______

Social Security Number D.O.B.

PART B. Previous Enrollment.

1. During the 12 months prior to the term for which you are applying,

did you attend a Public College or University in Texas in a Fall or

Spring term?

Yes

No.

If you answered “

No

,” continue to

PART C

.

If you answered “

Yes

” complete questions (2-4)

2. What Texas public institution did you last attend? (Give full name)

3. In which terms were you last enrolled?

Fall, 20___

Spring, 20___

4 .During your last semester at a Texas public institution, did you pay

resident (in-state) or nonresident (out-of-state) tuition?

Resident

(in-state)

Nonresident

(out-of-state)

Unknown

5. If you paid in-state tuition at your last institution, was it because you

were classified as a Texas resident or because you were a nonresident

who received a waiver?

Resident

Nonresident with a waiver

Unknown

IMPORTANT

:

If you were enrolled at a Texas public institution

during a fall or spring semester within the previous 12 months and were

classified as a Texas resident, skip to PART I. If you were not enrolled,

or if you were enrolled but classified as a nonresident, proceed to

PART C.

PART C. Residency Claim:

Are you a resident of Texas?

Yes

No

If you answered “

Yes

,” continue to

PART D

.

If you answered “

No

,” complete the following question and continue to

PART I

. Of what state or country are you a resident?

_____________________________________________________

If you are

uncertain

, continue to

PART D

.

PART D. Acquisition of High School Diploma or GED

1. Did you graduate from High School or complete a GED in Texas?

Yes

No

2. If you graduated from High School, give the full name and city of the

school. _________________________________________________

_______________________________________________________

3. Did you live or will you have lived in Texas the 36 months leading

up to high school graduation or completion of the GED?

Yes

No

4. When you begin the semester for which you are applying, will you

have lived in Texas for the previous 12 months?

Yes

No

5. Are you a U. S. Citizen or Permanent Resident?

Yes

No

Instructions to Part D :

♦ If

you answered “

No

” to question (1) or (3) or (4), continue to

PART E

.

♦

If you answered “

Ye

s” to all four questions, skip to

PART I

♦

If you answered “

Yes

” to questions (1), (3) and (4), but “

No

” to

question (5), skip to

PART I

of this form. Complete and receive an

Affidavit

from the Residence Determination Official in the Office of

Admissions.

PART E. Basis of Claim to Residency.

(To Be Completed By

Everyone Who Did Not Answer “Yes” to Questions (1), (3)

and (4) of PART D.)

1. Do you file your own federal income tax as an independent tax

payer?

Yes

No

2. Are you claimed as a dependent or are you eligible to be claimed as

a dependent by a parent or court-appointed legal guardian?

Yes

No

(

To be eligible to be claimed as a dependent, your parent or legal

guardian must provide at least one half of your support. A step-parent

does not qualify as a parent if he or she has not adopted the student

.)

3. If you answered “

No

” to both questions above, who provides the

majority of your support?

Self

Parent or Legal Guardian

Other

: (list)______________________________________

Instructions to PART E:

♦

If you answered “

Ye

s” to question (1), continue to

PART F.

♦

If you answered “

Yes

” to question (2), skip to

Part G

.

♦

If you answered “

No

” to (1) and (2) and “

Self

” to question (3),

continue to

PART F

.

♦

If you answered “

No

” to (1) and (2) and “

Parent or Legal

Guardian

” to question (3), skip to

PART G

.

♦

If you answered “

No

” to (1) and (2) and “

Other

” to question (3),

skip to

PART H

and complete

PART I.

.

PART F. If you answered “Yes” to question (1) or “Self” to

question (3) of Part E, answer the following:

1. Are you a U.S. Citizen?

Yes

No

2. Are you a Permanent Resident of the United States of America?

Yes

No

3. Are you a foreign national whose application for Permanent Resident

Status has been preliminarily reviewed?

(

You should have received a

fee/filing receipt or Notice of Action (I-797) from U. S. Citizenship

and Immigration Services (USCIS) showing your I-485 has been

reviewed and has not been rejected.

)

Yes

No

4. Are you a foreign national here with a visa or are you a Refugee,

Asylee, Parolee or here under Temporary Protective Status? If so,

indicate Visa/Status __________________________________

5. Do you currently live in Texas?

Yes

No

If “

No

”, are you out of state due to a temporary assignment by your

employer or other temporary purpose, please explain in

Part H

6. (a) If you currently live in Texas, how long have you been living

here?

Months

____________

Years

__________

(b) What is your main purpose for being in the state?

Go to College

Establish/Maintain a Home

Work Assignment

(If for reasons other than those listed above, give an explanation

PART H

).

7. (a) If you are a member of the U.S. military, is Texas your Home of

Record?

Yes

No

(b) What state is listed as your military legal residence for tax

purposes on your Leave and Earnings Statement?

__________________________________

8. Do any of the following apply to you? (Check all that apply)

(a) Hold the title to real property (home, land) in Texas?

Yes

No

If “

Yes

”, date acquired: ___________________________

(b) Own a business in Texas?

Yes

No

If “

Yes

”, date acquired: __________________

(c) Do you hold a state or local license to conduct a business or

practice a profession in Texas?

Yes

No

If “

Yes”

, date acquired: ___________________________

9. For the past 12 months, have you: (Check all that apply)

(a) Been gainfully employed in Texas?[Gainful employment:

lawful activities intended to provide an income to a person or

allow a person to avoid the expense of paying another person to

perform the tasks (as in child care or the maintenance of a

home). A person who is self-employed, employed as a home-

maker, or who is living off his/her earnings may be considered

gainfully employed for tuition purposes, as may a person whose

primary support is public assistance.]

Yes

No

(b) Received services from a social service agency that provides

services to homeless persons for at least a consecutive 12-month

period?

Yes

No

10.(a)Are you married to a person who could answer “

Yes

” to any part

of question (8) or (9)?

Yes

No

(b) If “

Yes

,” indicate which question could be answered “

Yes

” by

your spouse: ________________________________________

(c) How long have you been married to the Texas resident?

Months _______ Years _______

Skip Part G and continue to Part H.

Part G. Questions for students who answered “Parent” or

“Legal Guardian” to question (3) of Part E.

1. Is the parent or legal guardian upon whom you base your claim of

residency a U.S. Citizen?

Yes

No

2. Is the parent or legal guardian upon whom you base your claim of

residency a Permanent Resident of the United States of America?

Yes

No

3. Is this parent or legal guardian a foreign national whose application

for Permanent Resident Status has been preliminarily reviewed?

(Your parent or legal guardian should have received a fee/filing

receipt or Notice of Action (I-797) from U. S. Citizenship and

Immigration Services (USCIS) showing the I-485 has been reviewed

and has not been rejected.)

Yes

No

4. Is this parent or legal guardian a foreign national here with a visa or a

Refugee, Asylee, Parolee or here under Temporary Protective

Status? If so, indicate Visa/Status: ____________________________

5. Does this parent or legal guardian currently live in Texas?

Yes

No

If he or she is out of state due to a temporary assignment by his or

her employer or other temporary purpose, please explain in

PART H

6.(a)If your parent or legal guardian is currently living in Texas, how

long has he or she been living here?

Months _______ Years _______

(b) What is your parent’s or legal guardian’s main purpose for being

in the state?

Go to College

Establish/Maintain a Home

Work Assignment

(

If for reasons other than those listed above, give an explanation in

PART H

).

7. (a) If your parent or legal guardian is a member of the U.S. military,

is Texas his or her Home of Record?

Yes

No

(b) What state is listed as your parent’s or legal guardian’s

residence for tax purposes on his or her Leave and Earnings

Statement? _____________________________________

8. Do any of the following apply to your parent or legal guardian?

(check all that apply)

(a) Hold the title to real property (home, land) in Texas?

Yes

No

If

Yes

, date acquired: ___________________________

(b) Own a business in Texas?

Yes

No

If Yes, date acquired: _________________________

(c) Hold a state or local license to conduct a business or practice a

profession in Texas?

Yes

No

If Yes, date acquired:_________________________

9. For the past 12 months, has your parent or guardian: (check all that

apply)

(a) Been gainfully employed in Texas? [Gainful employment: lawful

activities intended to provide an income to a person or allow a

person to avoid the expense of paying another person to perform

the tasks (as in child care or the maintenance of a home). A

person who is self-employed, employed as a homemaker, or who

is living off his/her earnings may be considered gainfully

employed for tuition purposes, as may a person whose primary

support is public assistance.]

Yes

No

(b) received services from a social service agency that provides

services to homeless persons?

Yes

No

10 (a) Is your parent or legal guardian married to a person who could

answer “

Yes

” to any part of question (8) or (9)?

Yes

No

(b) If “

Yes

,” indicate which question could be answered “

Yes

” by

your parent or guardian spouse: __________________________

(c) How long has your parent or legal guardian been married to

the Texas resident? Months _______Years _______

PART H. General Comments. Is there any additional

information that you believe Galveston College should know in

evaluating your eligibility to be classified as a resident? If so,

please provide it below

:

PART I. Certification of Residency

. ( All students must complete

this section.)

I understand that officials of Galveston College. Will use the

information submitted on this form to determine my status for

residency eligibility. I authorize G.C. to verify the information I have

provided. I agree to notify the proper officials of the institution of any

changes in the information provided. I certify that the information on

this application is complete and correct and I understand that the

submission of false information is grounds for rejection of my

application, withdrawal of any offer of acceptance, cancellation of

enrollment and/or appropriate disciplinary action.

________________________________________________________

Signature

_________________________