1. education
2. graduate school
3. college

UNM College Prep Programs (CPP)-College Readiness Program
Application for 2015-2016 Session
Complete CPP-College Readiness Application Packet Includes:
□ Student Application
□ Additional Student Information
 Extracurricular Activities Information
□ Parent/Guardian Information
 Student and Parent/Guardian Financial Information
□ Parent/Guardian and Student Consent Form
As part of this application you also need to attach:
□ Participant Essays (Essay Prompts Included with Application Packet)
□ Essay #1
□ Essay #2
□ Nomination Form #1: Academic Nomination (Nomination Form Included with Application Packet)
□ Teacher
□ Counselor
□ Principal
□ Other
□ Nomination Form #2: Community Nomination (Nomination Form Included with Application Packet)
□ Neighbor □ Employer or Coach
□ Community or Religious leader
□ Other: ________________________________
 State of New Mexico Dual Credit Request Form
 UNM Application (No Application Fee Required)
 Sealed Official High School Transcript
Note: Only two nomination letters will be read. Applications not completed in full will not be considered. Do not leave
any fields blank.
Return all of the above material to:
College Prep Programs (CPP)
Attention: C/O Stacy Collier
1 University of New Mexico
MSC 02 1630
Albuquerque, NM 87131
-orFax: (505) 277-3165
ALL MATERIALS MUST BE RECEIVED BY 5:00 PM ON Friday, April 3rd, 2015
Late applications will not be considered.
Questions? Contact College Prep Programs at (505) 277-0401
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
The College Readiness Program consists of four components: a 3 day, 2 night summer session, twice monthly
Saturday seminars, biweekly meetings with a personal Educational Mentor Tutor on the UNM campus, which
take place throughout the participants’ senior year of high school and dual-credit.

Summer Session - College Readiness Participants will live on campus for 3 days/2 nights and
experience the academic and social life the university offers. The summer session consists of a
philanthropy activity, college readiness preparation workshops and presenters, leadership skills
activities, and team building exercises.

Senior Year Monthly Seminars - Participants are required to attend two (2) monthly Saturday seminars
on campus throughout their senior year where continuous information and help is offered with the goal
of successfully matriculating every participant in a post-secondary education institution. The seminars
cover topics such as the college application process, financial aid options and application processes,
career exploration, college exploration, how to write a resume, cover letter, and personal statement.
Students are also guided through the application process for scholarships such as the Daniel’s Fund
Scholarship and the Gates Millennium Scholars Scholarship. Participation in the program does not
guarantee being a recipient of either scholarship.

Senior Year meetings with Educational Mentor Tutors - Students meet with their Educational
Mentor/Tutor (EMT) who provides one-on-one help with scholarship searches and processes, financial
aid and any other help the student might need. Students meet with their EMT once every other week on
the UNM Campus.

Dual-Enrollment - All College Readiness Program Participants who successfully complete our program
will receive 6 (3 per semester) elective college credits and 2 (1 per semester) elective high school
credit*. This is a new component to our program and a great opportunity for students to earn college
and high school credit and learn the skills for becoming a successful college student.
*With eligible schools.
Eligibility






Currently be a Junior in a high school in the Albuquerque metro and surrounding areas who will be
graduating in 2016.
Be considered low income by the standards of the US Department of Education.
Students must be nominated by their high school academic counselor/school official during the spring
semester of the student’s junior year.
At the time of nomination student must have a 2.5 minimum cumulative GPA.
Must participate in the College Readiness Summer Residential Program. (Tentative dates: MondayWednesday, June 8-10, 2015)
Must follow through with the requirements discussed in the mandatory parent/student meeting. (Saturday,
May 2, 2015 at 10:00am at the University of New Mexico)
ALL MATERIALS MUST BE RECEIVED BY 5:00 PM ON Friday, April 3rd, 2015
Notifications of the student’s application status will be mailed out by April 13, 2015
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
STUDENT APPLICATION
STUDENT (APPLICANT) COMPLETES THIS SECTION
Please print or type. Do not leave any blanks. Enter O (zero) or N/A if not applicable. Blank spaces will delay
processing and may cause your application to be incomplete or denied. Applications must be completed in full.
Do not leave any fields blank.
Last Name
First Name
Middle Initial
Social Security Number (if unavailable, please see program staff)
Mailing Address
Gender (for summer housing purposes)
City
Home Phone
Shirt Size
Date of Birth
State
Cell Phone
S
M
L
Zip Code
E-mail Address
 XL  ____XL (write number for 2XL, 3XL and so on)
School Information
Earned School Credit Hours
Cumulative Grade Point Average
School
Expected Graduation Date
School District (i.e. APS, Rio Rancho, etc.)
School Mailing Address
City
School Counselor
Office Phone
Education and Career Goals
Did at least one of your parents/legal guardians finish a 4-year degree?
Do you want to attend college?  Yes  No
State
Zip Code
E-mail Address
 Yes  No
Briefly describe your professional goals? Do you need to go to college to reach your goals?
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
ADDITIONAL STUDENT INFORMATION
Please print or type. Do not leave any blanks. Enter O (zero) or N/A if not applicable. Blank spaces will delay
processing and may cause your application to be incomplete or denied. Applications must be completed in full. Do not
leave any fields blank.
How did you hear about this program?
Summer Housing (TBD)
Please provide us with the following information to assist us with your housing needs during the summer residential or
non-residential component, if selected.
Do you have a physical disability requiring accommodations?
If yes, please describe:
 Yes  No
Ethnic & Race Information
The University of New Mexico is required by federal law to request this information for statistical reporting purposes.
Your response is voluntary.
1. What is your ethnicity?
 Hispanic or Latino
 Not Hispanic or Latino
2. Select one or more of the following racial categories to describe yourself:
 American Indian
 Asian
 Black or African American
 White
 Hawaiian or Other Pacific Islander
3. Are you an enrolled member of a tribe?
 Apache
 Navajo
 Southern Ute
 Pueblo (including Hopi)
 Native Alaskan
 Other tribal group:
What languages do you speak?
Primary language spoken in your home
Secondary language spoken in your home
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
EXTRACURRICULAR ACTIVITIES INFORMATION
Please check all the activities or clubs you are involved with at your school:
Sports:
 Baseball
 Basketball
 Football
 Soccer
 Softball
 Swimming
 Tennis
 Volleyball
 Wrestling
Clubs:








Choir
DECA
Drama
Ethnic Clubs
MESA
National Honor Society
Senate/Student Council
Science Club
Other commitments (work, other programs, etc.):
Taking into consideration the above commitments, are you able to commit to participating in the biweekly College
Readiness Program Saturday classes from 9am-1pm on the UNM Main Campus?


YES
NO
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
PARENT/GAURDIAN INFORMATION
PARENT(S) OR LEGAL GUARDIAN(S) COMPLETE THIS SECTION
Please print or type. Do not leave any blanks. Enter O (zero) or N/A if not applicable. Blank spaces will delay processing and may
cause your application to be incomplete or denied. Applications must be completed in full. Do not leave any fields blank.
Parent/Guardian #1
Relationship to student
Last Name
First Name
Mailing Address
Home Phone
Middle Initial
City
Cell Phone
State
Zip Code
E-mail Address
Education Level (last grade completed or diploma/degree received)
Occupation
Work Phone
Parent/Guardian #2 (if applicable)
Relationship to student
Last Name
First Name
Mailing Address
Home Phone
Middle Initial
City
Cell Phone
State
Zip Code
E-mail Address
Education Level (last grade completed or diploma/degree received)
Occupation
Work Phone
Emergency Contact (not Parent or Guardian)
Last Name
Home Phone
First Name
Cell Phone
Middle Initial
Work Phone
Relationship to student
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
STUDENT AND PARENT FINANCIAL INFORMATION
STUDENT AND PARENT(S)/LEGAL GUARDIAN(S) COMPLETE THIS SECTION
Please print or type. Do not leave any blanks. Enter O (zero) or N/A if not applicable. Blank spaces will delay processing and may cause your application to be
incomplete or denied. Applications must be completed in full. Do not leave any fields blank.
Student Financial Information (REQUIRED)
Are you currently participating in a government program?
 Yes
 No
 Not Sure
Did you file a 2013 Federal Income Tax Return?
 Yes
 No
 Will file
Did your parents or legal guardian claim you as a dependent on a federal income tax return in 2013?
 Yes
 No
With whom do you currently reside?
 Both Parents
 Mother
 Father
 Legal Guardian
 Other
Parent/Legal Guardian Financial Information (REQUIRED)
2013 or 2014 Financial Information for Parent(s) or Legal Guardian(s)
A. Adjusted gross income (AGI) – reported income before taxes are calculated on Federal
Income Tax Return (tax filers only). This can be found on your 2013 or 2014 IRS form
1040; 1040A; 1040Ez; or Telefile.
A. $
B. Number reported in
household:
B. ________
Please write any additional information about your financial situation you need to communicate to the program below:
STATEMENT OF CERTIFICATION
I certify that all information given in this application and supporting documentation is complete and accurate to the best of my knowledge. I hereby give The University
of New Mexico – CPP College Readiness Program permission to secure and access educational or financial records necessary for my participation in the program
and/or provide comprehensive support services and/or activities. This information will be kept confidential in accordance with the FERPA Privacy Act of 1974.
Inaccurate, false, or undocumented information may lead to dismissal from the program.
Student’s Name (please print)
Student’s Signature
Date
Parent’s/Guardian’s Name (please print)
Parent’s/Guardian’s Signature
Date
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
Parental/Guardian and Student Consent
We hereby give permission for my son/daughter to attend the CPP-College Readiness Program at the University of New
Mexico (UNM). We understand that our child’s participation in this program is fully voluntary and not required for
admission to UNM. We understand room and board will be provided at an on-campus dormitory and educational
mentor/tutors will serve as chaperones 24-hours per day in the campus dormitories and at all daily activities. Our
son/daughter will be required to comply with UNM and CPP-College Readiness rules and regulations, as well as all
Federal, State and Local laws and regulations. We have received and read the program rules and responsibilities.
We understand that our child will participate in off-campus activities. We further understand that UNM and the CPPCollege Readiness Program will supervise all off-campus, planned activities of our child. However, all students must be
in compliance with and abide by all rules, regulations and policies established by UNM and the CPP-College Readiness
Program. The University of New Mexico CPP-College Readiness Program will not be responsible for any accidents,
injuries or other misfortune which may occur as a result of a participant’s violation of these rules, regulations or policies.
If the student decides to leave the program voluntarily before the advertised end date, the CPP-College Readiness
Program will release the student only into the custody of the parent/legal guardian and will not be responsible for the
student after he/she leaves the UNM campus. The CPP-College Readiness Program reserves the right to disenroll a
student at any time due to a violation of any rule, regulation or policy established by UNM and/or the CPP-College
Readiness Program.
We understand and acknowledge that certain risks are inherent to participating in recreational activities due to one’s own
actions, the actions of other participants or a combination of both. These risks may result in injury, minor or serious, as
well as damage to personal property. Knowing the risks, and in consideration of being permitted to participate in the
Program, we agree that any claim my child or I may have now or in the future against UNM, its officers, employees or
agents, arising out of our participation in this program shall be governed by the law, of the state of New Mexico. This
includes the New Mexico Tort Claims Act, Section 41-4-1 et seq., NMSA 1978, as amended. We understand that the
New Mexico Tort Claims Act imposes limitations and restrictions upon civil law suits against UNM and its employees.
We are aware of all personal medical needs of my child and there are no health related reasons or problems which
preclude or restrict my child’s participation in this program. We understand that UNM does not provide health or
accident insurance for program participants, nor is UNM responsible to pay for any medical services that my child may
need.
We have read and understand this form before signing it. We understand that if we have any questions we can ask the
program for an explanation. This agreement shall be governed by the laws of the state of New Mexico, which shall be the
form for any lawsuits filed arising from the program. We declare that all information provided in this application is true
and accurate to the best of our knowledge.
I give permission to the CPP-College Readiness Program to use any slides, photographs, images, video and/or statements
that may be taken of my child during the course of the program for marketing and/or promotional purposes.
Print Participant’s Name
Print Parent/Legal Guardian’s Name
Participant’s Signature
Parent/Legal Guardian’s Signature
Date
Date
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
Participant Essay Questions
Instructions
Please type your answers to the following questions on additional sheet(s) of paper using Times New Roman,
12 point font, and 1 inch margins. Limit each answer to approximately 250 - 500 words. Your name, high
school, and essay topic (see below) should appear in the top right-hand corner of each page.
Question 1:
What is the greatest principle that guides your life? Where do you believe this came from?
Question 2:
Where do you see yourself in 10 years? Tell us about your career goals and life aspirations. What steps
will you need to take to make these goals a reality?
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
College Prep Programs (CPP) 2015-2016 College Readiness Program
NOMINATION FORM 1 (ACADEMIC) – PLEASE RETURN THIS FORM WITH YOUR APPLICATION
To the Student
Please fill in your name and high school on the lines below and give this nomination form to the individual you have selected to
provide a nomination for you.
Applicant’s Name
Name of School
To the Nominating Individual
The student named above is applying to CPP-College Readiness Program, a program that helps prepare students for the college
admission and financial aid processes. This program seeks to identify students who demonstrate the following characteristics:






Financial need;
Academic performance or promise;
Interest in pursuing higher education;
Strength of character, evidence of leadership potential, and emotional maturity and stability;
Well rounded personality, abilities, and broad interests; and
The potential to contribute to one’s community later in life.
Please provide contact information listed below to allow easier contact from the CPP-College Readiness Program in case of any
pending questions or concerns we may have.
Nominator Name:
Phone Number:
E-mail:
Relationship to Applicant:
To help the selection committee determine whether this student merits entry to the program, please prepare answers that address ALL
of the following questions: Please limit your answers to the allotted space provided.
Please submit your nomination letter in a sealed envelope to the student prior to the application deadline of Friday, April 3rd,
2015 for CPP-College Readiness Program.
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
Applicant Name
1. What are this student’s strongest qualities?
2. How has this student demonstrated leadership at home, in the community, on a team, in the workplace, or in
the arts?
3.
Describe a circumstance when this student overcame an obstacle or challenge by using his or her ethics,
values, and/or spiritual beliefs.
4. Please indicate how this student will likely contribute to the community in the future.
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
College Prep Programs (CPP) 2015-2016 College Readiness Program
NOMINATION FORM 2 (COMMUNITY) – PLEASE RETURN THIS FORM WITH YOUR APPLICATION
To the Student
Please fill in your name and high school on the lines below and give this nomination form to the individual you have selected to
provide a nomination for you.
Applicant’s Name
Name of School
To the Nominating Individual
The student named above is applying to CPP-College Readiness Program, a program that helps prepare students for the college
admission and financial aid processes. This program seeks to identify students who demonstrate the following characteristics:






Financial need;
Academic performance or promise;
Interest in pursuing higher education;
Strength of character, evidence of leadership potential, and emotional maturity and stability;
Well rounded personality, abilities, and broad interests; and
The potential to contribute to one’s community later in life.
Please provide contact information listed below to allow easier contact from the CPP-College Readiness Program in case of any
pending questions or concerns we may have.
Nominator Name:
Phone Number:
E-mail:
Relationship to Applicant:
To help the selection committee determine whether this student merits entry to the program, please prepare answers that address ALL
of the following questions: Please limit your answers to the allotted space provided.
Please submit your nomination letter in a sealed envelope to the student prior to the application deadline of Friday, April 3rd,
2015 for CPP-College Readiness Program.
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
Applicant Name
1. What are this student’s strongest qualities?
2. How has this student demonstrated leadership at home, in the community, on a team, in the workplace, or in
the arts?
3.
Describe a circumstance when this student overcame an obstacle or challenge by using his or her ethics,
values, and/or spiritual beliefs.
4. Please indicate how this student will likely contribute to the community in the future.
The University of New Mexico CPP-College Readiness in an initiative of the Division of Student Affairs and College Enrichment & Outreach
Programs (CEOP) College Prep Programs with support and funds from the New Mexico State Legislature.
State of New Mexico
Dual Credit Request Form
Summer
x Fall
Spring
x 2015
Student Information
Last Name
First Name
MI
Date of Birth
STARS Student ID#
Social Security number *
Mailing Address
City
State
Zip
Residency – NM County
High School Name
Gender
Telephone
Expected Graduation Date
HS ACT Code
High School GPA
Ethnicity *
*Social Security number or ethnicity are not required for dual credit participation.
Course Listing and Secondary/Postsecondary Approval
The above-named student has been given permission to enroll as a dual credit student. Based on this student’s academic record and overall maturity, I feel
he/she will be successful in college level courses. Therefore, as high school representative, I recommend the student take the following course(s):
Schedule #
e.g. CRN #
Course #,
e.g. MATH
121
Course
Section #
ACAD 101
Course Title, e.g. College
Algebra
College Readiness
Day(s)
(MTWThF)
S
Time, e.g.
1-1:30pm
Location of Course
Higher
Education
Credits
9:00-1:00
3
High
School
Credits
1
FERPA Release Information
We, the student and parent/guardian, agree for the above-named student to enroll in the Dual Credit Program offered in coordination with stated high
school and postsecondary institution. We understand the high school representative will authorize course selection for each term. We understand that
all prerequisite requirements, including assessment and course placement must be met.
We agree to abide by the guidelines in the Statewide Dual Credit Master Agreement, and high school and postsecondary policies and codes of conduct.
We will cooperate with both the high school and postsecondary institution in fulfilling student responsibilities. We understand that any courses registered
for, or grades earned, become a permanent part of the student’s high school and college record. At the end of each quarter and/or semester, we
authorize the postsecondary institution to send all grades to the postsecondary school, including those for courses that are not a part of this agreement.
We understand that it is the student’s responsibility to receive approval from the high school representative for permission to drop or withdraw from the
course(s) listed above.
According to the Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99), all rights of access to the student’s
educational records transfer from parent to student when the student is enrolled in a postsecondary institution. Accordingly, dual credit students still
enrolled in high school have rights of access to their postsecondary dual credit records. In order for the student to receive credit, transcripts of dual
credit courses will be shared among the secondary and postsecondary institutions the public education department, and the higher education
department. All data submitted to secondary and postsecondary institutions or the NMHED will be used and maintained in accordance with all federal
and state statutes, regulations, and policies.
By signing below, I, the student, authorize the postsecondary institution listed above, to release all information concerning my academic records to my
high school, the NMPED, and the NMHED. I understand that information may be released orally, electronically, or on paper. I have the right to inspect
any written records released pursuant to this consent and understand that I may revoke this consent at any time.
We, the student and parent/guardian, certify that all the information furnished in this application is true to the best of our knowledge. We understand
that any misrepresentation of the facts may result in the immediate cancellation of the student application or registration.
Signatures
High School Representative Signature
Date
High School Representative Name (print/type)
Student Signature
Date
Postsecondary Representative Signature
Parent/Guardian Signature
Date
Postsecondary Representative Name
Date
Administrative Purposes at the Postsecondary Institutions
Dual Credit Form Received by (print/type name
Completed/Signed Dual Credit Request
Form
English
ACT Scores
Math
Reading
Date
Entered by (print/type name)
Student meets cours e(s )
prerequi s i tes
Date
Student hi gh s chool trans cri pt
recei ved (i f appl i cabl e)
Postsecondary Institutional PLACEMENT Scores
Reading
Writing
Math
Other Comments:
Agreement
of Parties
A. STUDENTS AND PARENTS OR GUARDIANS
Endorsement of the Form by the STUDENT and PARENT, unless the STUDENT is 18 years old, shall be evidence that they possess an awareness of, and agree with the
following provisions. For purposes of this agreement, Local Education Agency (LEA) means public school districts, state chartered charter schools, state-supported
schools and bureau of Indian education-funded high schools.
1. Admission and Enrollment of Students. For a student to be accepted and enrolled into a dual credit program, the STUDENT shall:
a. Discuss potential dual credit courses with the appropriate LEA and POSTSECONDARY INSTITUTION staff, including POSTSECONDARY INSTITUTION
admission and registration requirements, course requirements, credits to be attempted, credits to be awarded, scheduling under dual credit, and implications
for failure to successfully complete the course;
b. Obtain course requirements for each course, including course prerequisites, course content, grading policy, attendance requirements, course completion
requirements, performance standards, and other related course information;
c. Meet the prerequisites and requirements of the course(s) to be taken;
d. Complete the Form available online or in hard copy from LEA or POSTSECONDARY INSTITUTION;
e. Return the Form with the specific courses requested, required signatures and, if applicable, a current high school transcript, and copies of any assessment
results to LEA representative;
f. Obtain approval for enrolling in the dual credit program each semester by acquiring all necessary signatures on the Form and submit form to POSTSECONDARY
INSTITUTION representative;
g. Register for courses during POSTSECONDARY INSTITUTION’s standard registration periods (Note: enrollments shall not be permitted after the close of posted
late registration);
h. Discuss any request for a change in registration (add, drop, withdrawal), recognizing that “audit” is not allowed for a dual credit course, and complete all
necessary forms and procedures with appropriate LEA and POSTSECONDARY INSTITUTION staff; and
i. Comply with POSTSECONDARY INSTITUTION and LEA student code of conduct and other institutional policies.
2. Rights and Privileges of Student. The right and privileges of STUDENTS participating in Dual Credit include:
a. The rights and privileges equal to those extended to LEA and POSTSECONDARY INSTITUTION students, unless otherwise excluded by any section of this
Agreement;
b. The use of POSTSECONDARY INSTITUTION library, course related labs and other instructional facilities, use of POSTSECONDARY INSTITUTION programs and
services such as counseling, tutoring, advising, and special services for the students with disabilities, and access to POSTSECONDARY INSTITUTION personnel and
resources as required; and
c. The right to appeal, in writing to LEA or POSTSECONDARY INSTITUTION, as applicable, any decision pertaining to enrollment in the dual credit program.
3. Financial Responsibility for Funding Dual Credit. The STUDENT shall:
a. Return the textbooks and unused course supplies to LEA when the student completes the course or withdraws from the course;
b. Arrange transportation to the site of the dual credit course. Depending upon the time and course location, the student may have access to transportation
through LEA if the dual credit course is offered during the school day; and
c. Be responsible for course-specific (e.g. lab, computer) fees.
4. Confidentiality of Student Records.
a. Student educational records created as a result of this Agreement shall be retained and disseminated in accordance with FERPA requirements;
b. Participation in dual credit courses requires STUDENT and/or PARENT/GUARDIAN signatures on the Dual Credit Form to comply with FERPA regulations.
5. Secondary School and Postsecondary Institution Calendars.
The regular operating institutional calendar and schedule of POSTSECONDARY INSTITUTION shall be observed by STUDENTS earning dual credits. Dual credit
STUDENTS are required to comply with the requirements of both LEA and POSTSECONDARY INSTITUTION official calendars. In instances in which the calendars
are incongruent, the dual credit STUDENT is required to independently satisfy both calendar requirements and may consult with school counselors for assistance.
B. LEA. Endorsement of the Dual Credit Form shall be evidence the LEA has and will comply with the provisions outlined in the Agreement between the
POSTSECONDARY INSTITUTION and the LEA.
C. POSTSECONDARY INSTITUTION. Endorsement of the Dual Credit Form by the POSTSECONDARY INSTITUTION shall be evidence that the POSTSECONDARY
INSTITUTION has and will comply with the provisions outlined in the Agreement between the LEA and POSTSECONDARY INSTITUTION.
APPLICATION for UNDERGRADUATE ADMISSION
Be sure to answer all questions completely. Questions left unanswered may delay your admission.
1. Application for (select one):
2. Enrollment Status:
x Fall
☐
☐ Degree
- USE BLACK INK ONLY -
☐ Spring
☐ Summer
Year 20 1 5
☐ Non-Degree ☐x High School Dual Credit/Concurrent
3. Legal name:
Last
4. Previous name(s):
First
Middle
Suffix
If your educational records have ever been under another name, include the name under which transcripts will arrive.
5. Social Security Number (REQUIRED*):
* The Federal Privacy Act of 1974 requires that you be notified that disclosure of your SSN is mandatory based on University regulation. Your SSN is used to ensure an accurate academic record and to provide full access to all services such as financial aid. Your SSN will not be used as your primary University identification number. If you are unable to provide a SSN, the University will assign an alternative number to you. This will not impact the admission decision.
6. Mailing address:
Number and Street or PO Box
City
Permanent Address:
Number and Street or PO Box
City
State
Zip
State
Zip
E-mail address:
7. OPTIONAL: If your parent/guardian would like to receive information about UNM, please provide an e-mail address:
E-mail address:
8. Phone number(s):
9. Gender:
☐ Male ☐ Female
10. Date of birth:
11. Birth City:
12.Are you a United States citizen?
☐ Yes ☐ No
Month
Day
Year
Birth State or Foreign Country:
Note: If you are not a U.S. citizen, also complete the information below.
THIS SECTION IS TO BE FILLED OUT BY NON-U. S. CITIZENS
Country of Birth: Are you a permanent resident?
Country of Citizenship:
☐ Yes ☐ No ☐ Residency Pending
Alien Registration Number:
If you answered NO to the question above, you must respond to the following questions:
Do you presently have a visa?
☐ Yes ☐ No
If yes, indicate type:
What type of visa do you expect to hold while at The University of New Mexico?
☐ Student ( F-I ) ☐ Other (specify):
☐ Student ( F-I ) ☐ Other (specify):
To view international application and admission guidelines, please go to: http://geo.unm.edu
13. Race and Ethnicity: The University of New Mexico is required by Federal law to request this information for statistical reporting purposes. Your response is voluntary.
Do you consider yourself to be Hispanic/Latino(a)?
☐ Yes ☐ No
In addition, select one or more of the following racial categories to describe yourself.
☐ American Indian or Alaska Native (Principal tribal group:
☐ Asian
☐ Native Hawaiian or Pacific Islander
☐ Black or African American
☐ White
)
Federal Race and Ethnicity Definitions:
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, South or Central American, or Spanish culture
or origin, regardless of race.
American Indian or Alaska Native
A person having origins in any of the original peoples of the North and South America
(including Central America) who maintains cultural identification through tribal affiliation
or community attachment.
Asian
A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
14. Are you active-duty Military/National Guard/Reserves?
Are you a veteran?
☐ Yes ☐ No
Black or African American
A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other
Pacific Island.
White
A person having origins in any of the original peoples of Europe, the Middle East, or North
Africa.
☐ Yes ☐ No
☐ Yes ☐ No
Are you a spouse or dependent of an active-duty member of the military?
For information and required documentation on tuition waivers for veterans and their dependents, please see http://vrc.unm.edu.
☐ Yes ☐ No
15. Did either of your parents or guardians graduate from a four-year college or university?
16. Intended field of study (Degree seeking only):
Please refer to page 4 for a list of colleges and degrees.
17. High school:Graduation Date:
Name
City
State
18. If not a high school graduate, have you earned a GED certificate? ☐ Yes
☐ No
Date GED Earned:
19. College Entrance Exams:
☐ ACT ☐ SAT
Date taken or plan to take:
Month
Month
Year
Month
Year
Year
20. Have you ever been convicted of, pled guilty to, or charged with a felony offense in any court?*
☐ Yes ☐ No
*If yes, you must attach a detailed explanation. Include state and location, dates, and case number. If applicable, provide the name and phone number of your parole or probation officer.
You are under a continuing obligation to immediately update your response to this question if your circumstances change after you submit this application.
21. List all institutions at the college level, including UNM, that you have ever attended (or currently attend) and request an official
transcript from each institution to be sent to the UNM Office of Admissions. Do not list study abroad programs separately if
they are included as part of a transcript program from an accredited U.S. institution. Failure to report all institutions attended
may result in delay of admission, loss of credit, or dismissal from the University. You do not need to submit transcripts from
UNM. NOTE: Non-Degree applicants do not need to submit transcripts.
Name of Institution
City and State
22. Have you previously taken courses at any UNM Campus?
From
Month
Year
☐ Yes ☐ No
To
Month
Year
Dates:
23. Have you ever been suspended from any college or university (including UNM) for any reason?
☐ Academic
Institution
Credit Hrs
Earned
Date of Suspension
☐ Yes ☐ No
☐ Disciplinary
Degree
Earned
24. List all current courses (either high school or college) you are now taking and/or plan to take before enrolling at UNM:
Name of Institution
Course Number and Title
Credits
IN-STATE TUITION CLASSIFICATION
A New Mexico resident is a person who has, or a dependent person whose parent or legal guardian has, established and maintained legal residency in New Mexico
for at least the past twelve consecutive months. NOTE: If you are under the age of 23, also complete the Parent/Guardian information below.
Do you regard New Mexico as your permanent residence? If no, refer to question 25.
Have you lived in New Mexico for at least the past 12 consecutive months?
STUDENT
PARENT or GUARDIAN
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
If you have not lived in New Mexico for at least the past 12 consecutive months, please provide an explanation below:
Student
Explanation:
Parent/Guardian
Explanation:
☐ Yes
☐ Yes
☐ Yes
☐ Yes
☐ Yes
☐ Yes
Are you currently registered to vote in New Mexico?
Do you have a current New Mexico driver’s license?
Do you have a vehicle currently registered in New Mexico?
Are you currently registered to vote in another state?
Do you have a current driver’s license from another state?
Do you have a vehicle currently registered in another state?
☐ No
☐ No
☐ No
☐ No
☐ No
☐ No
☐ Yes
☐ Yes
☐ Yes
☐ Yes
☐ Yes
☐ Yes
☐ No
☐ No
☐ No
☐ No
☐ No
☐ No
The following situations may qualify you for resident tuition. Contact the Admissions Office for information at 505-277-8900.
• Certified member of a nation, pueblo, or tribe located wholly or partially in New Mexico.
• Member or a dependent of a member of the U.S. Armed Forces or National Guard.
• Relocation to New Mexico for employment or retirement.
25. Non-New Mexico Residents: The New Mexico Amigo Scholarship Program provides scholarship opportunities to
well-qualified degree-seeking students based on a selective review of college entrance exams and GPA scores. Would you
like UNM to consider you for any non-resident scholarship opportunities for which you may be qualified?
☐ Yes ☐ No
For more information regarding UNM scholarships visit http://scholarship.unm.edu.
APPLICATION FEES:
Freshman/Transfer - $20
Non-Degree to Degree - $20
Readmit - $15
Non-Degree - $10
(A fee is not required for transferring from Associate Degree status at a UNM Branch Campus to Bachelor Degree status if within three
semesters of last attending a UNM Branch. If beyond three semesters, the $15 readmit fee applies.)
Mail the completed & signed application and non-refundable application fee to:
UNM Admissions, PO Box 4895, Albuquerque NM 87196-4895
I certify that all information given in this application is complete and accurate to the best of my knowledge. If I am accepted as a student at the
University of New Mexico, I agree to conform and abide by the letter and spirit of all rules, regulations, and procedures of the University. Misrepresentation in any statement by the applicant or failure to abide by University academic regulations will be considered adequate grounds
for denying admission, for cancellation of registration, or for suspension from the University.
SIGNATURE
SOCIAL SECURITY NUMBER
DATE OF BIRTH
DATE
The University of New Mexico is an Affirmative Action/Equal Opportunity institution. To comply with the ADA and the Rehabilitation Act of 1973, UNM provides this
publication in alternative formats. If you have special needs and require an auxiliary aid or service, please let us know.
FOR OFFICE
USE ONLY
Application Fee Paid:
☐ Yes
Amount: $
☐ No
☐ Check #
☐ Cash ☐ Receipt #Initials
COLLEGES AND DEGREES
Anderson School of Management
Business Administration (B.B.A.)
School of Architecture and Planning
Architecture (B.A.A.)
Environmental Planning & Design
(B.A.E.P.D.)
College of Arts and Sciences
Africana Studies (B.A.)
American Studies (B.A.)
Anthropology (B.A., B.S.)
Asian Studies (B.A.)
Astrophysics (B.S.)
Biochemistry (B.A., B.S.)
Biology (B.A., B.S.)
Chemistry (B.A., B.S.)
Classical Studies (B.A.)
Communication (B.A.)
Comparative Literature & Cultural Studies (B.A.)
Criminology (B.A.)
Earth and Planetary Sciences
(B.A., B.S., B.S.Ed.)
Economics (B.A.)
English (B.A., B.A.Ed.)
English-Philosophy (B.A.)
Environmental Science (B.S.)
European Studies (B.A.)
French (B.A.)
Family Studies (B.A.)
Geography (B.A., B.S.)
German (B.A.)
Health, Medicine, and Human Values (B.A.)
History (B.A.)
International Studies (B.A.)
Journalism and Mass Communication (B.A.)
Languages (B.A.)
Latin American Studies (B.A.)
Linguistics (B.A.)
Mathematics (B.S.)
Philosophy (B.A.)
Physics (B.S.)
Physics and Astrophysics (B.A.)
Political Science (B.A.)
Portuguese (B.A.)
Psychology (B.A., B.S.)
Religious Studies (B.A.)
Russian (B.A.)
Signed Language Interpreting (B.S.)
Sociology (B.A.)
Spanish (B.A.)
Speech and Hearing Sciences (B.A.)
Statistics (B.S.)
Women Studies (B.A.)
College of Education
Art Education (B.A.Ed.)
Athletic Training (B.S.)
Early Childhood Multicultural Education (B.S.)
Elementary Education (B.S.Ed.)
Exercise Science (B.S.)
Family Studies (B.S.)
Health Education (B.S.Ed.)
Human Development and Family
Relations (B.S.)
Nutrition and Dietetics (B.S.)
Physical Education (B.S.Ed.)
Secondary Education (B.S.Ed., B.A.Ed.)
Special Education (B.S.Ed.)
Theatre (B.A.Ed.)
Computer Science (B.S.C.S.)
Construction Engineering (B.S.Cn.E.)
Construction Management (B.S.C.M.)
Electrical Engineering (B.S.E.E.)
Mechanical Engineering (B.S.M.E.)
Nuclear Engineering (B.S.N.E.)
College of Fine Arts
Art History (B.A.)
Art Studio (B.A., B.F.A.)
Dance (B.A.)
Interdisciplinary Film and Digital Media (B.F.A.)
Design for Performance (B.A.)
Media Arts (B.A.)
Music (B.A., B.M.)
Music Education (B.M.E.)
Theatre (B.A.)
Health Sciences
Dental Hygiene (B.S.D.H.)
Emergency Medical Services (B.S.)
Medical Laboratory Sciences (B.S.M.L.)
Radiologic Sciences (B.S.)
College of Nursing
Nursing (B.S.N.)
University College
Native American Studies (B.A.)
University Studies (B.U.S.)
University Libraries
Technology and Training (B.S.)
School of Engineering
Chemical Engineering (B.S.Ch.E.)
Civil Engineering (B.S.C.E.)
Computer Engineering (B.S.Cp.E.)
Colleges and Degrees are subject to change. Visit http://catalog.unm.edu for updates.
APPLICATION & CREDENTIAL DEADLINES
Applications for admission are reviewed on a rolling basis. Admission decisions are issued by mail after all application materials
are complete. Students are advised to apply early in the event of the need for additional information or supporting documentation.
For priority consideration, apply by the following dates:
Spring Semester ............................ November 15
Summer Semester..........................May 1
Fall Semester ..................................May 1
SOCIAL SECURITY NUMBERS
The Federal Privacy Act of 1974 requires that you be notified that disclosure of your Social Security Number is mandatory based
on University regulation. Your SSN is used to ensure an accurate academic record and to provide full access to all services, such
as financial aid. Your SSN will not be used as your primary University identification number. If you are unable to provide a Social
Security Number, the University will assign an alternative number to you. This will not impact the admission decision.
07/2014