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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 Identification Number (ITIN). We will use your SSN/ITIN to report Hope Scholarship/Lifetime Learning
tax credit; to administer state/federal financial aid; to verify enrollment, degree and academic transcript records; and to conduct institutional 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 penalties (refer to Internal Revenue Service Treasury Regulation 1.6050S-1(e)(4) for more information). Pursuant to state law (RCW 28B.10.042) and federal law
(Family Educational 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 driver’s license or state ID?
If yes, in what state is your current driver’s 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 committed to a policy of equal opportunity in employment and student enrollment. All programs are free from discrimination and harassment against any person because of race, creed, color, national or ethnic origin, sex, sexual orientation, gender identity 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, genetic information, honorably discharged veteran or military status or any other prohibited basis per RCW 49.60.030, 040 and other federal and state laws and regulations, or participation in the complaint process. The following persons have been designated to handle inquiries regarding the non-discrimination policies and Title IX compliance for both the Wenatchee and Omak campuses:
To report discrimination or harassment: Title IX Coordinator, Wenatchi Hall 2322M, (509) 682-6445, title9@wvc.edu.
To request disability accommodations: 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 attended:
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 applicant’s signature ______________________________________________________Date _____________
APPLICANT’S SIGNATURE
Date received : ______________ Received by: ___________________________________________________________
OFFICE USE ONLY
Res Stat Letter 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
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