Colorado New Mexico Student Exchange San Juan College
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1
2San Juan College
New Mexico-Colorado Tuition Reciprocity Agreement
Application
In order to be considered for participation in the Colorado and New Mexico Student Exchange Program
as a Colorado resident attending San Juan College, the student must meet the following guidelines.
Reside in one of the following Colorado counties: Archuleta, Dolores, La Plata, Montezuma, or
San Juan County
Be enrolled or have applied to enroll at San Juan College as a degree-seeking student.
Submit this application and supporting documents no later than the first day of the term.
_____________________________________________________________________________________
The steps for consideration for reciprocal tuition based on the New Mexico-Colorado Tuition Reciprocity
Agreement include completion of this form and copies of 2 of the 4 items listed below. Please print
legibly.
1. Driver’s License
3. Voter Registration
2. Vehicle Registration
4. Copy of Colorado tax return (most recent)
_________________________________________________________
_______-______-________
Name: Last
First
Middle
Social Security Number
_____________________________________________________________________________________________________________________
Mailing Address
City
State
Zip
_____________________________________________________________________________________________________________________
Physical Address of Residence
City
State
Zip
____________________________________________________
__________________
______________________
Dates of residence at this address – list month and year.
From: Month/Year
To: Month/Year
/
/
_____________________________________________________
________
_______
_______________
County of Residence
Date of Birth:
Month
Day
Year
(
)
-
_____________________________________________________
__________
____________
______________________
Program of Study at SJC
Phone Number:
Previous Address
If residing for less than 12 months at the address listed above, please complete this section. List previous address as
well as the month and year for the dates of residence.
Student Address:________________________________________ From: __________To:_________
Spouse Address:________________________________________
From: __________To:_________
Parent Address: _________________________________________ From: __________To:_________
‐OVER‐
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