Csn Residency Application Form PDF Details

The CSN residency application form is a document that allows students to apply for residency status at the college. The form can be downloaded from the CSN website, and must be completed in full before submission. In order to be considered for residency, applicants must meet certain eligibility requirements. Full details on how to apply and what is required can be found on the CSN website.

Question	Answer
Form Name	Csn Residency Application Form
Form Length	5 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 15 sec
Other names	E-L, Nevada, csn student tax forms, NRS

Form Preview Example

RESIDENCY APPLICATION

Last Name

CSN reserves the right to request additional information when deemed appropriate. All submitted documentation becomes the property of CSN and will not be returned to the student. Please retain a copy of all submitted documentation. Students will be notified of their residency decision via email to the address listed on MyCSN, however, all tuition and fees must be paid by the published date indicated in the current class calendar to avoid late penalties. The granting of resident (in-state) student status will apply to the semester for which this application was accepted along with future semesters. No decision shall be retroactive.

Name _______________________________________________________________________________________________________

LastFirstMiddle Initial

Social Security or NSHE ID Number _______________________________________ Date of Birth __________________________

Address______________________________________________________________________________________________________

____________________________________________________________________________________________________________

CityStateZipCountyCountry of Citizenship

Telephone ______________________________E-mail _______________________________________________________________

Term of Entry	❑ Fall 20______	❑ Spring 20______
	year	year

First Name

The rules and regulations for determining whether students shall be classified as resident or nonresident for tuition charges are covered by the Board of Regents of the Nevada System of Higher Education (NSHE) and may be found under Title 4, chapter 15 of the Board of Regents Handbook.

Armed Forces of the United States is defined as the Army, Navy, Air Force, Marine Corps, and the Coast Guard, on active duty and does not include the National Guard or other reserve force, with the exception of active members of the Nevada National Guard.

A student enrolled at College of Southern Nevada under the Good Neighbor program (prior to spring 2012 semester) or the Western Undergraduate Exchange program (WUE) must withdraw in writing from the program and pay full nonresident tuition for at least 12 months after which she or he may apply for reclassification to resident student status.

NOTE: A student holding a visa other than a permanent immigrant visa, or has been granted official asylum or refugee status is not eligible for Nevada residency status. Proof of U.S. citizenship (birth certificate, certificate of naturalization, or U.S. passport) or permanent resident card may be required.

Declaration of Intent of Residency (Not applicable for category K)

I hereby declare that I have abandoned any domicile or residence in any state or commonwealth of the United States of America other than the State of Nevada. I further certify that I have established a bona fide domicile or residence in the State of Nevada with the intent of making Nevada my true, fixed, and permanent home and place of habitation, having clearly abandoned my former domicile or residence and having no intent to make any other location outside the State of Nevada my home and habitation.

I further certify that to the extent it is required for me to qualify as a resident for purposes of tuition, I have been domiciled or a resident in the State of Nevada for at least 12 months immediately prior to the date of my anticipated matriculation to resident student status and that, therefore, I have been physically present and residing in Nevada for that entire period of time, excluding short-term absences for business or pleasure. The information provided on this application and supporting documentation are true to the best of my knowledge. I understand that omissions or misrepresentations will invalidate consideration for in-state residency.

Date _______________ ___________________________________________	__________________________________________
Student Signature	Parent/Spouse signature (for financially dependent student)
___________________________________________	__________________________________________
Student’s Name	Name of Parent/Spouse

Filing a false Declaration of Intent of Residency will result in the payment of nonresident tuition for the period of time a student was enrolled as a resident student and may also lead to the disciplinary sanctions under Title 2, Chapter 6 of the Nevada System of Higher Education Code. Disciplinary sanctions include a warning, reprimand, probation, suspension, or expulsion.

Residency Application

Instructions:

1. Determine if you are a new or current student.

New Student: Anyone who plans on attending CSN but has not started classes can apply for Nevada residency in the New Student category (A or B) or All Inclusive category (E-L).

Current Student (reclassification): Anyone who has previously completed a class at CSN should apply for Nevada residency using the Current Student category (C or D) or All Inclusive category (E-L).

2.Place a check mark next to the single category of Nevada state residency for which you are applying.

3.Mail or Hand-deliver your signed application and photocopies of your required documents to the appropriate office listed below. Please note that you will not be exempt from tuition payment deadlines. Only approved applications are subject to reimbursement. The granting of resident (in-state) student status will apply to the semester for which this application was accepted along with future semesters. Decisions made on residency applications that are completed after the fee payment deadline take effect in the next semester. No decision shall be retroactive.

Office of the Registrar

West Charleston Campus

6375 W. Charleston Blvd.

Building D

Las Vegas, Nevada 89146

(702) 651-5610

Office of the Registrar

Cheyenne Campus

3200 E. Cheyenne Ave.

Main Building

North Las Vegas, Nevada 89030

(702) 651-4060

Office of the Registrar

Henderson Campus

700 College Drive

Building B

Henderson, Nevada 89002

(702) 651-3030

New Student Categories (A or B)

Current students or those who have previously attended as defined on page 2 are not eligible to apply for Nevada residency in this category.

		Residency Status	Required Documents

	❑	A financially dependent person	Please submit clear photocopies for all the following:
		whose spouse, parent or legal
		guardian has resided in Nevada for			Federal Tax return for the spouse, parent, or legal guardian for the most
		guardian has resided in Nevada for		___
		at least 12 months immediately			recent tax year that indicates the applicant as a dependent for the prior 12
		prior to the date the student begins			month period with a valid Nevada address.
		classes at CSN.			Student’s birth certificate, adoption documents, or marriage certificate
		classes at CSN.		___
					AND
		Please Note:	Also, the spouse, parent, or legal guardian must provide one of the following
			documents:
		All documents must prove
		residency for the 12 months prior		___	Evidence of physical, continuous presence in the State of Nevada for
A		to the date the student begins			12 months (i.e. a lease agreement, rent receipts, utility receipts)
		classes at CSN.
				___	A Nevada driver’s license or Nevada identification card
				___	A Nevada driver’s license or Nevada identification card
					A Nevada vehicle registration
				___	A Nevada vehicle registration
				___	A Nevada voter registration

				___	Evidence that the student’s spouse, parents or legal guardian have relocated
					to Nevada for the primary purpose of permanent full-time employment or to
					establish a business in Nevada. Spouse, parent, or legal guardian must
					provide a signed letter from employer on company letterhead stating start
					date and permanent full-time position of employment and at least one pay
					stub from the current employer or a copy of a Nevada business license and
					proof that the business is in operation.

				___	Any other evidence that objectively documents intent to abandon residence
					in any other state and to establish a Nevada residence

	❑	A financially independent person	Please submit clear photocopies for all the following:
		who has resided in Nevada for at
		least 12 months immediately prior		___	The federal tax return for the most recent tax year indicating a Nevada
		to the date the student begins			address. If no federal tax return has been filed by the student because of
B		classes at CSN.			minimal or no taxable income, provide documented information concerning
					the receipt of such nontaxable income. If the student is under the age of 24,
					a copy of the parent’s or legal guardian’s tax return for the most recent tax
					year that indicates the student was not claimed as a dependent
					Continued on page 3

			2

	Residency Status	Required Documents

	Please Note:			AND
		Also, provide one of the following documents:
	All documents must prove
	residency for the 12 months prior		___	Evidence of physical, continuous presence in the State of Nevada for
	to the date the student begins			12 months (i.e. a lease agreement, rent receipts, utility receipts)
	classes at CSN.		___	A Nevada driver’s license or Nevada identification card
				A Nevada vehicle registration
			___	A Nevada vehicle registration
B			___	A Nevada voter registration

			___	Evidence that the student has relocated to Nevada for the primary purpose of
			___
				permanent full-time employment or to establish a business in Nevada
				Student must provide a signed letter from employer on company letterhead
				stating start date and permanent full-time position of employment and at
				least one pay stub from the current employer or a copy of a Nevada business
				license and proof that the business is in operation
			___	Any other evidence that objectively documents intent to abandon residence
				in any other state and to establish a Nevada residence

Current Student Categories (C or D)

New students as defined on page 2 are not eligible to apply for Nevada residency in this category.


	❑	A financially dependent person	Please submit clear photocopies for all the following:
		A financially dependent person	Please submit clear photocopies for all the following:
		whose spouse, parent or legal
		guardian has resided in Nevada		___		Parent, legal guardian or spouse and student’s signature on the Declaration
		with a valid Nevada address for at				of Intent of Residency (see front of application)
		least 12 months immediately prior		___		Federal income tax and W-2 for the most recent tax return listing
		to the date the student begins				student/spouse as dependent that indicate a Nevada address
		classes at CSN.			___	Student’s birth certificate or documentation indicating legal guardianship
						for proof of dependency if child is dependent. Submit a copy of marriage
		Please Note:				certificate if spouse is dependent
						AND
		All documents must be issued	Proof of Bona fide Residence in Nevada
		at least 12 months prior to the	Your parent, legal guardian or spouse must document continuous physical presence
		date of the application for	as a bona fide Nevada resident for at least twelve (12) months immediately prior to
		reclassification	the date of the application for reclassification. No fewer than four additional pieces
			of the following objective evidence must be submitted with your application for
			reclassification.
				___		Nevada driver’s license or Nevada identification card issued twelve (12)
						months prior to the date of application
				___		Ownership of a home in Nevada
C				___		Lease of living quarters in Nevada
						Mortgage or rent receipts and utility receipts for the home or leased quarters
				___

				___		Nevada vehicle registration issued twelve (12) months prior to the date of
						application
				___		Nevada voter registration issued twelve (12) months prior to the date of
						application
			Proof of Intent to Remain in Nevada
			Your parent, legal guardian or spouse must present clear and convincing, objective
			evidence of intent to remain a Nevada resident. No fewer than three of the following
			pieces of objective evidence must be submitted with your application for
			reclassification.
				___		Employment in Nevada for twelve (12) months immediately prior to the date
						of the application for reclassification
				___		A license for conducting a business in Nevada
						Admission to a licensed practicing profession in Nevada
					___	Admission to a licensed practicing profession in Nevada

					___	Evidence of active savings and checking accounts in Nevada financial
						institutions for at least twelve (12) months immediately prior to the date of
						the application
					___	A Nevada address listed on selective service registration

					___	Payment of property tax in Nevada
						Evidence of summer term enrollment at an NSHE institution
					___	Evidence of summer term enrollment at an NSHE institution
						Continued on page 4


				___			Voting or registering to vote in Nevada
C
C				___			Any other evidence that objectively documents intent to abandon residence
							in any other state and to establish a permanent Nevada residence


	❑	A financially independent person	Please submit clear photocopies for all the following:
		who has been a resident of Nevada
		for a period of at least 12			___		Signed Declaration of Intent of Residency (see front of application)
		continuous months immediately			___		Federal income tax return and W-2s for the most recent year that indicate
		prior to the date of application for					a Nevada address. If you were under the age of 24 for the most current
		reclassification. Student must					tax year, a copy of your parent or legal guardian’s income tax return for
		provide evidence of financial					that year must be submitted indicating that your were not claimed as a
		independence and must present					dependent
		clear, convincing, objective					AND
		evidence of intent to remain a	Proof of Bona fide Residence in Nevada
		Nevada resident.	You must document continuous physical presence as a bona fide Nevada resident for
			at least twelve (12) months immediately prior to the date of the application for
		Please Note:	reclassification. No fewer than four additional pieces of the following objective
			evidence must be submitted with your application for reclassification.
		All documents must be issued
		at least 12 months prior to the		___			Nevada driver’s license or Nevada identification card issued twelve (12)
		date of the application for					months prior to the date of application
		reclassification		___			Ownership of a home in Nevada
							Lease of living quarters in Nevada
				___			Lease of living quarters in Nevada
							Mortgage or rent receipts and utility receipts for the home or leased quarters.
				___
				___			Nevada vehicle registration issued twelve (12) months prior to the date of
D							application
D					___		Nevada voter registration issued twelve (12) months prior to the date of
					___
							application
			Proof of Intent to Remain in Nevada
			You must present clear and convincing, objective evidence of intent to remain a
			Nevada resident. No fewer than three of the following pieces of objective evidence
			must be submitted with your application for reclassification.
				___			Employment in Nevada for twelve (12) months immediately prior to the date
							of the application for reclassification
				___			A license for conducting a business in Nevada
				___			Admission to a licensed practicing profession in Nevada
				___			Evidence of active savings and checking accounts in Nevada financial
							institutions for at least twelve (12) months immediately prior to the date of
							the application for reclassification
					___		A Nevada address listed on selective service registration
					___		Evidence of summer term enrollment at an NSHE institution
					___		Voting or registering to vote in Nevada

						___	Any other evidence that objectively documents intent to abandon residence
							in any other state and to establish a permanent Nevada residence

All Inclusive Categories (E–L)

Current and New Students are eligible to apply for Nevada residency using the following categories.

		Residency Status	Required Documents

	❑	Nevada high school graduate	Please submit a clear photocopy for the following:
E		(Does not include Certificate of
E		Attendance or General Education		___		A copy of your Nevada high school diploma or final transcripts
		Attendance or General Education		___
		Developmental – GED Test)				indicating the date of graduation

	❑	A student who has established	Please submit a clear photocopy for the following:
F		residency at another Nevada System of
F		Higher Education institution (i.e.			___	Official letter indicating your Nevada residency status
		Higher Education institution (i.e.			___	Official letter indicating your Nevada residency status
		UNLV, UNR, GBC, TMCC, NSC, WNC)

		A teacher who is employed full	Please submit clear photocopies for all the following:
	❑	A teacher who is employed full	Please submit clear photocopies for all the following:
		time by a private elementary,
		secondary, or postsecondary		___				A copy of your current employment contract
		institution whose curricula meet
G		the requirements of NRS 394.130	Provide the following if applying as the spouse or dependent:
G		or the spouse or dependent of
		or the spouse or dependent of
		such an employee		___				Birth certificate or marriage certificate
				___				Proof of parent/legal guardian/spouse filing of federal income tax return for
								the most recent tax year. Must indicate applicant as spouse or dependent
				___				A copy of the educational staff’s current employment contract

		A professional employee, classified	Please submit clear photocopies for all the following:
	❑	A professional employee, classified	Please submit clear photocopies for all the following:
		employee, postdoctoral fellow,
		resident physician, or resident			___			A copy of your current employment contract
		dentist of the Nevada System of
H		Higher Education who is currently	Provide the following if applying as the spouse or dependent:
H		employed at least half time or the
		employed at least half time or the
		spouse or dependent of such an		___				Birth certificate or marriage certificate
		employee			___			Proof of parent/legal guardian/spouse filing of federal income tax return for
								the most recent tax year. Must indicate applicant as spouse or dependent
				___				A copy of the educational staff’s current employment contract

		A licensed educational personnel	Please submit clear photocopies for all the following:
	❑	A licensed educational personnel	Please submit clear photocopies for all the following:
		employed full time by a public
		school district in the state of		___				A copy of your current employment contract
		Nevada or the spouse or dependent
I		of such an employee	Provide the following if applying as the spouse or dependent:
								A birth certificate or marriage certificate
				___				A birth certificate or marriage certificate
								Proof of parent/legal guardian/spouse filing of federal income tax return for
					___
								the most recent tax year. Must indicate applicant as spouse or dependent

		A former member of the U.S.	Please submit clear photocopies for all the following:
	❑	A former member of the U.S.	Please submit clear photocopies for all the following:
		Armed Forces who relocated from
		Nevada as a result of a permanent		___				A copy of all military orders showing relocation from Nevada
		change of duty station pursuant to						A copy of military discharge orders verifying that you returned to Nevada
J		change of duty station pursuant to		___
J		military orders.						within one year of being discharged
		military orders.						within one year of being discharged
						___		A copy of an unexpired Nevada driver’s license issued at least 12 months
								immediately prior to the date of relocation orders or evidence of absentee
								voting from the State of Nevada

		A member of the U.S. Armed Forces	Please submit clear photocopies for all the following:
	❑	A member of the U.S. Armed Forces	Please submit clear photocopies for all the following:
		on active duty stationed in Nevada
		as a result of a permanent change of			___		A copy of military identification and military orders
		duty station pursuant to military
K		orders or a person whose spouse,	Provide the following if applying as the spouse or dependent:
K		parent, or legal guardian is a
		parent, or legal guardian is a
		member of the U.S. Armed Forces		___			Dependents or spouse must submit a birth certificate or marriage certificate
		stationed in Nevada as a result of a						along with the military identification and military orders for the active
		permanent change of duty station						member
		pursuant to military orders

		A member of a Native American	Please submit clear photocopies for all the following:
	❑	A member of a Native American	Please submit clear photocopies for all the following:
L		tribe who is currently residing on
L		tribal land located wholly or			___		Proof of bloodline or tribal enrollment card
		partially within the boundaries of					Documentation proving residency on tribal lands within the State of Nevada
		partially within the boundaries of		___
		Nevada

OFFICIAL USE ONLY

SEMESTER: _______________			Approved	Denied
________________________________________	____________	________________________________________			____________
Signature	Date	Notification sent to student			Date

How to Edit Csn Residency Application Form Online for Free

Through the online PDF tool by FormsPal, it is easy to fill out or edit Henderson here. The editor is constantly improved by us, receiving powerful functions and growing to be better. To get started on your journey, take these basic steps:

Step 1: Press the "Get Form" button above on this page to open our PDF tool.

Step 2: The editor grants the ability to customize almost all PDF forms in many different ways. Enhance it by writing customized text, correct original content, and place in a signature - all doable within minutes!

It will be easy to finish the form using out helpful guide! Here's what you want to do:

1. Whenever submitting the Henderson, ensure to incorporate all essential blanks in the relevant section. This will help hasten the process, allowing for your details to be processed promptly and properly.

2. Your next part would be to complete all of the following blanks: I further certify that to the, Date, Student Signature, ParentSpouse signature for, Students Name, Name of ParentSpouse, and Filing a false Declaration of.

NSHE writing process explained (stage 2)

3. In this specific part, review Residency Status, Required Documents, A financially dependent person, Please submit clear photocopies, Federal Tax return for the spouse, recent tax year that indicates the, Students birth certificate, AND, Please Note, Also the spouse parent or legal, All documents must prove, residency for the months prior, Evidence of physical continuous, to the date the student begins, and months ie a lease agreement rent. Every one of these will have to be filled out with highest focus on detail.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Please submit clear photocopies, The federal tax return for the, address If no federal tax return, Continued on page, and A financially independent person - to proceed further in your process!

In terms of The federal tax return for the and Continued on page, ensure you don't make any errors here. These are the key fields in the file.

5. As you near the final parts of this form, you will find a few more requirements that should be met. Mainly, AND Also provide one of the, All documents must prove, residency for the months prior, Evidence of physical continuous, to the date the student begins, months ie a lease agreement rent, classes at CSN, A Nevada drivers license or, permanent fulltime employment or, Any other evidence that, in any other state and to, Current Student Categories C or D, A financially dependent person, Please submit clear photocopies, and Parent legal guardian or spouse should be filled in.

Step 3: Prior to moving forward, check that all form fields are filled out as intended. Once you establish that it's correct, click “Done." Find your Henderson the instant you register online for a 7-day free trial. Immediately use the pdf document from your FormsPal cabinet, with any modifications and changes conveniently synced! FormsPal ensures your data confidentiality with a secure method that never records or distributes any type of personal data used. You can relax knowing your documents are kept protected any time you work with our service!

Csn Residency Application Form – Fill Out and Use This PDF

Csn Residency Application Form PDF Details

Form Preview Example

How to Edit Csn Residency Application Form Online for Free

Csn Residency Application Form isn’t the one you’re looking for?

Csn Residency Application Form – Fill Out and Use This PDF

Csn Residency Application Form PDF Details

Form Preview Example

How to Edit Csn Residency Application Form Online for Free

Csn Residency Application Form isn’t the one you’re looking for?

Related Documents