Please print clearly & use blue or black ink.

Submitted for the semester of:

California Nonresident Tuition Exemption Request

California Nonresident Tuition Exemption Request For Eligible High School Graduates. Complete and sign this form to
request an exemption from Nonresident Tuition. You must submit any documentation required by the College or Univer-
sity (for example, proof of high school attendance in California). Contact the California Community College, University of
California or California State University campus where you intend to enroll (or are enrolled) for instructions on documenta-
tion, additional procedures and applicable deadlines.
Eligibility:
I, the undersigned, am applying for a California Nonresident Tuition Exemption for eligible California high school
graduates at CERRITOS COLLEGE and I declare the following:
Check YES or NO boxes:

YES NO I have graduated from a California high school or have attained the equivalent thereof, such as a
High School Equivalency Certificate, issued by the California State GED Office or a Certificate of
Proficiency, resulting from the California High School Proficiency Examination.

YES NO I have attended high school in California for three or more years.

Provide information on all school(s) you attended in grades 9-12th:

Documentation of high school attendance and graduation (or its equivalent) is required by the University of California.
The California State University and some Community Colleges. Follow Campus Instructions .

Check the box that applies to you– Check only one box:

I am a nonimmigrant alien as defined by federal law; [including, but not limited to, a foreign student
(F Visa) or exchange visitor (J visa)].
OR
I am NOT a nonimmigrant alien ( including, but not limited to, a U.S. Citizen, permanent resident, or an alien
without lawful immigration status).
AFFIDAVIT:
I, the undersigned, declare under penalty of perjury under the laws of the State of California that the information I have provided on this form is true and accu-
rate. I understand that this information will be used to determine my eligibility for nonresident tuition exemption for eligible California high school graduates. I
hereby declare that ,if I am an alien without lawful immigration status, I have filed an application to legalize my Immigration status or will file an application as
soon as I a eligible to do so. I further understand that if any of the above information is untrue, I will be liable for payment of all nonresident charges from which I
was exempted and may be subject to disciplinary action by the College or University.

Print Full Name (As it appears on your campus student records) Campus/Student Identification Number

Print Full Mailing Address Email Address (Optional) Phone Number ( Optional)

( ) —
Signature Date:
 California Nonresident Tuition Exemption
For Eligible California High School Graduates
(The law passed by the Legislature in 2001 as “AB 540” )

GENERAL INFORMATION
Any student, other than a nonimmigrant alien, who meets all of the following requirements, shall be exempt from paying nonresident tuition at
the California Community Colleges, the University of California, and the California State University (all public colleges and universities in Califor-
nia).

Requirements:

1. The student must have attended a high school (public or private) in California for three or more years.
2. The student must have graduated from a California high school or attained the equivalent prior to the start of the term (for example, passing
the GED or California High School Proficiency exam).
3. An alien student who is without lawful immigration status must file an affidavit with the college or university stating that he or she has filed
an application to legalize his or her immigration status, or will file an application as soon as he or she is eligible to do so.

Students who are nonimmigrants [for example, those who hold F (student) visas, B (visitor) visas, etc.] are not eligible for this exemption.

The student must file an exemption request including a signed affidavit with the college that indicates the student has met all applicable condi-
tions described above. Student information obtained in this process is strictly confidential unless disclosure is required under law.

Students eligible for this exemption who are transferring to another California public college or university must submit a new request (and docu-
mentation if required) to each college under consideration.

Nonresident students meeting the criteria will be exempted from the payment of nonresident tuition, but they will not be classified as California
residents. They continue to be “nonresidents.”

AB540 does not provide student financial aid eligibility for undocumented alien students. These students are eligible for state aid for terms on or
after January 1, 2013.

PROCEDURES FOR REQUESTING THIS EXEMPTION FROM NONRESIDENT TUITION

California Community Colleges: Complete the form on the reverse. Submit it to the Admissions Office at the community college where you are
enrolled or intend to enroll. You may be required to submit additional documentation. Call the college Admissions Office if you have questions.

University of California: The University of California (UC) system has its own nonresident tuition exemption application and affidavit form, but it
will accept the exemption request form used by the California Community Colleges and the California State University. Your campus has estab-
lished deadlines for submission of exemption requests; however, requests are not to be submitted until you have been admitted to a UC cam-
pus. Some students, such as transfer, graduate, and professional students, also must submit their official high school transcripts; check your cam-
pus for specific instructions. Once you are determined to be eligible for the exemption, you will continue to receive it as long as you fulfill the
eligibility requirements or until the University no longer offers this exemption. The exemption covers the Nonresident Tuition Fee and the Educa-
tional Fee differential charged to nonresident students. Applying for the exemption does not alter your responsibility to pay by the campus dead-
line any nonresident tuition and associated fees that may be due before your eligibility is determined. For general information, visit the following
website: www.ucop.edu/sas/sfs/ppolicies/ab540faqs.htm. For campus-specific instructions regarding documentation and deadline dates, contact
the campus Office of the Registrar.

California State University: Complete the form on the reverse. Contact the Office of Admissions and Records at the CSU campus where you are
enrolled or intend to enroll for instructions on submission, deadline information, and additional requirements. You will be required to submit
final high school transcripts and appropriate records of high school graduation or the equivalent, if you have not done so already. Call the Office