Admissions Application
Admissions Application
Eastfield College
3737 Motley Drive
Mesquite, TX 75150
972-860-7167
www.efc.dcccd.edu/
El Centro College/BPI
801 Main Street
Dallas, TX 75202
214-860-2000
www.ecc.dcccd.edu/
Richland College
12800 Abrams Road
Dallas, TX 75243
972-238-6100
www.rlc.dcccd.edu/
Admissions
Application
for the
Colleges of the Dallas County Community College District
Educational opportunities are offered by the Dallas County Community College District without regard to race,
color, religion, gender, national origin, disability, sexual orientation, gender identity, gender expression, or any
other basis prohibited by law.
INSTRUCTIONS
1. All applicants must complete Part A and Part I.
2. Applicants wishing to claim Texas residence for tuition purposes must complete the
following:
Students of a Texas public college or university during the past 12 months, who paid
resident (in-state) tuition, without a tuition waiver, must complete Part A, B and I.
Applicants who did not attend a Texas public college or university during the past 12
months must complete Part A, B, C, D, E, F and I.
Part H is for any additional information an applicant believes the college should know
in evaluating Texas residence.
3. Applicants who are not claiming Texas residence for tuition purposes must complete Part
A, B, C and I only.
BIOGRAPHICAL INFORMATION
Questions with an asterisk (*) are voluntary, and the information provided will remain confidential.
In addition, supplying your social security number, gender, and ethnicity enables a more expedient
match of test scores, transcripts, financial aid benefits, and tuition refunds.
APPLICATION METHODS
Applicants may apply one of three ways:
1. An online application process is available for credit students at http://econnect.dcccd.edu.
2. Apply Texas Online Application www.ApplyTexas.org
3. An Adobe PDF version of the application is available to download and complete. Needs to be
submitted to the college Admissions office.
h t t p : / / www.dcccd.ed u/ wh y/ appl y/ adm i s s i on/ pages / defaul t .as p x
Please print in blue or black ink and complete all appropriate Parts.
The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect to
their education records. If you wish to protect your directory information from disclosure, proceed to
the following website or contact the Admissions/Registrars Office.
Student Name:
Student ID Number:
Brookhaven
Cedar Valley
Mountain View
North Lake
Eastfield
El Centro
Fall (Aug-Dec)
Winter Term (Dec/Jan)
Richland
Spring (JanMay)
May Term (May)
Summer (JunAug)
Admissions Application
Your responses to questions with an asterisk (*) are voluntary.
Your Social Security Number or tax identification number is required. Your number will remain confidential.
E-Mail Address:
Supplying your Social Security Number enables a more expedient match of your test scores, transcripts & financial aid benefits.
Choose One
NAME
County Code:
*GENDER
Give full legal name. Do not use initials unless initials are your legal name.
F
Last
First
Middle
Give names, if different from above, that are on transcripts from other institutions.
City
State
How Admitted:
Apartment
Zip
Term:
Citizen:
Rising Star:
* Ethnicity and Racial Background: (How do you identify yourself?) This information will be used for federal
and/or state law reporting purposes only.
Tech Prep:
Please select the racial category or categories with which you most closely identify. Check as many as apply.
___ White (1)
___ Native American/Alaskan (5)
Dual Credit:
Staff:
Uncertain (APPN.UNCERTAIN)
Military-Veteran Status If you have any military affiliations, please indicate by selecting all that apply:
Current/Former member of the US Armed Forces
Dependent of a veteran
-1-
Admissions Application
Student Name:
Student ID Number:
Educational Data
Name of High School Attended: _________________________________ City: _________________________ State: ______
Graduated/Expected Graduation Date (Month) _________ (Year) _________
Did not graduate from High School
Please answer each question:
Were you home schooled?
Yes
No
Did you take a Career Pathway course or courses for college credit?
Yes
No
Did or will you graduate with an IB diploma?
Yes
No
If you did not graduate from high school do you have a GED?
Yes
No
If yes, completion date (Month) _________ (Year) _________ which version:
In what state did you receive your GED? ______________
English
Spanish
Official transcripts for ALL previous college work MUST be submitted. Failure to list all institutions will be considered an
intentional omission and may result in the denial of future enrollment.
FROM
TO
(Month/Year) (Month/Year)
Hours
Credits
Degree Cert.
Received
(if any)
Currently on
Suspension
Yes / No
1.
2.
3.
4.
5.
STAAR
SAT
ACT
I have not taken one of the tests listed above. I understand that I may have to take a test prior to registration.
I have taken: TSIA or formerly approved TSI assessment (Accuplacer/Asset/Compass/THEA/TAKS)
Exemptions:
1. I am eligible for exemption from additional TSI assessment.
2. I claim an exemption because I am serving on active duty as a member of the U.S. armed forces, the Texas National Guard, or as a member
of a reserve component of the U.S. armed forces and have been serving for at least 3 years preceding enrollment.
Official documentation must be provided to prove exemptions.
3. I claim an exemption because I was honorably discharged, retired, or released from active duty as a member of the U.S. armed forces, the
Texas National Guard, or service as a member of a reserve component of the U.S. armed forces on or after August 1, 1990.
Official documentation must be provided to prove exemptions.
-2-
Admissions Application
Student Name:
Student ID Number:
During the 12 months prior to the term for which you are applying, did you attend a public college or
university in Texas in a fall or spring term?
YES
NO
__________________________________________
3. In which term were you last enrolled?
Fall, 20 _____
Spring, 20 _____
4. During your last semester at a Texas public institution, did you pay resident (in-state) or nonresident
(out-of-state) tuition?
resident (in-state)
nonresident (out-of-state)
unknown
5. If you paid in-state tuition at your last Texas public institution, was it because you were a Texas resident
or because you were a nonresident who received a waiver?
resident
nonresident with a waiver
unknown
IMPORTANT: If you were enrolled at a Texas public institution during a fall or spring semester within the
previous 12 months and were classified as a Texas resident,
SKIP TO Part I CERTIFICATION of INFORMATION,
SIGN and DATE THIS APPLICATION and SUBMIT.
If you were not enrolled, or if you were enrolled but classified as a nonresident,
proceed to Part C RESIDENCY CLAIM.
YES
NO
If you answered yes, continue to Part D ACQUISITION of HIGH SCHOOL DIPLOMA or GED.
If you answered no, complete the following question:
Of what state or country are you a resident? _____________________________
Continue to Part I CERTIFICATION of INFORMATION.
If you are uncertain, continue to Part D ACQUISITION of HIGH SCHOOL DIPLOMA or GED.
-3-
Admissions Application
Student Name:
Student ID Number:
No
Did you live in Texas or will you have lived in Texas the 36 consecutive months
leading up to high school graduation or completion of the GED?
(To answer Yes you must have graduated from a Texas public or private high school or earn or plan
to earn a GED. All others, including home-schooled students who do not plan to earn a GED, must
answer No.)
2.
When you begin the semester for which you are applying, will you have lived in
Texas for the previous 12 consecutive months?
YES
NO
(Independent tax payer should not be claimed as a dependent for tax purposes by another
person. If you file a joint return with your spouse, answer yes.)
2. Are you claimed as a dependent or are you eligible to be claimed as a dependent by a parent or
YES
NO
court-appointed legal guardian?
(To be eligible to be claimed as a dependent, your parent or legal guardian must provide more than
one-half of your support. A step-parent does not qualify as a parent if he/she has not adopted the
student.)
3. If you answered No to both questions above, who provides the majority of your support?
Self
Parent or Legal Guardian
Other: (list) ______________________________________
Instructions for Part E:
If you answered yes to question 1, go to Part
F.
G.
F.
-4-
Admissions Application
Student Name:
Student ID Number:
Part F: Questions for students who answered Yes to Question 1 or Self to Question 3 of Part E
Yes
No
Years
Months
Visa/Status
1. Are you a foreign national who has submitted an application for Permanent
Resident Status to the U.S. Citizenship and Immigration Service (USCIS) and
has received a fee/filing receipt or notice action (I-797) from USCIS showing
that your I-485 has gone through preliminary review and not been rejected?
Visa/Status
2. Are you a foreign national here with a visa eligible to domicile in the United
States or are you a Refugee, Asylee, Parolee, or here under Temporary
Protective Status?
If so, indicate which.
3. Do you currently live in Texas?
If you are out of state due to a temporary assignment or for another reason,
please answer NO & explain in Part H.
Years
4a. If you currently live in Texas, how long have you been living here?
b. What is your main reason for being in the state?
If for reasons other than those listed, give an explanation in Part H.
Months
Attend College
Work Assignment
Establish and Maintain a Home
Yes
No
5. If you are a member of the U.S. military, is Texas your Home of Record?
STATE
What state is listed as your military legal residence for tax purposes on your
Leave and Earnings Statement?
6. Do any of the following apply to you: (Check all that apply.)
Yes
No
Yes
No
Yes
No
Yes
No
a. Do you hold the title (warranty deed, deed of trust, or other similar instrument
that is effective to hold title) to residential real property in Texas?
If yes, date acquired: ______________________________________
b. Do you have ownership interest and customarily manage a business in
Texas without the intention of liquidation in the foreseeable future?
If yes, date acquired: ______________________________________
7a.
For the past twelve months have you been gainfully employed in Texas?
(Gainful employment requires an average employment of at least twenty hours per
week for one year or earnings equal to at least half of tuition and living expenses for one
nine month academic year. Employment conditioned on student status such as work
study, receipt of stipends, fellowships or research or teaching assistantships does not
constitute gainful employment.)
b. For the past twelve months, have you received primary support from a
social service agency?
8a. Are you married to a person who could answer yes to any part of
questions 6 or 7?
b. If yes, indicate which question could be answered yes by your spouse.
Question: ____________________
c. How long have you been married to the Texas resident?
Years
Months
-5-
Admissions Application
Student Name:
Student ID Number:
Part G: Questions for students who answered Parent or Legal Guardian to Question 3 of Part E
Yes
No
Years
Months
Visa/Status
1. Is the parent or legal guardian upon whom you base your claim of
residency a U.S. Citizen?
2. Is the parent or legal guardian upon whom you base your claim of
residency a Permanent Resident?
3. Is this parent or legal guardian a foreign national whose application for
Permanent Resident Status has been preliminarily reviewed?
(He or she should have received a fee/filing receipt or Notice of
Action [I-797C] from the USCIS showing his or her I-485 has been
reviewed and has not been rejected.)
4. Is this parent or legal guardian a foreign national here with a visa or is a
Refugee, Asylee, Parolee, or here under Temporary Protective Status?
If so, indicate which.
5. Does this parent or legal guardian currently live in Texas?
(If your parent or legal guardian is out of state due to a temporary job
assignment or for another reason, please explain in Part H.)
Visa/Status
Yes
No
Years
6a. If your parent or legal guardian is currently living in Texas, how long has
he or she been living here?
b. What is your parents or legal guardians main reason for being in the state?
If for reasons other than those listed, give an explanation in Part H.
Months
Attend College
Work Assignment
Establish and Maintain a Home
Yes
No
STATE
Yes
No
Yes
No
Yes
No
b. Does your parent or legal guardian have ownership interest and customarily
manage a business in Texas without the intention of liquidation in the
foreseeable future?
If yes, date acquired: ___________________________________
9. For the past twelve months has your parent or legal guardian:
a. Been gainfully employed in Texas?
(Gainful employment requires an average employment of at least twenty hours per
week for one year or earnings equal to at least half of tuition and living expenses for one
nine month academic year. Employment conditioned on student status such as work
study, the receipt of stipends, fellowships or research or teaching assistantships does not
constitute gainful employment.)
b.
10 a.
b.
c.
How long has your parent or legal guardian been married to the Texas
resident?
-6-
Years
Months
Admissions Application
Student Name:
Student ID Number:
Certificate of Understanding
I understand that officials of my college/university will use the information submitted on this form to determine my status for residency eligibility.
I authorize the college/university to verify the information I have provided, including my Texas Success Initiative (TSI) test scores and residency
information as necessary. I agree to notify the proper officials of the institution of any changes in the information provided. I certify that the
information in this application is complete and correct, and I understand that the submission of false information is grounds for rejection of my
application, withdrawal of any offer of acceptance, cancellation of enrollment, or appropriate disciplinary action.
I understand that my signature below verifies that I understand and will comply with the Meningitis requirement and Residency Oath stated above.
I will submit all official transcripts from all U.S. accredited institutions previously attended. I also verify that I have received or will receive
information about bacterial meningitis from the college as required by Section 51.9191 of the Texas Education Code.
Signature: _____________________________________
-7-
Date: ___________________
Admissions Application
Student Name:
Student ID Number:
The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect
to their education records. If you wish to protect your directory information from disclosure, proceed
to the following website or contact the Admissions/Registrars Office.
For information see: ht t p: / / econnect .dcc cd. edu
Educational opportunities are offered by the Dallas County Community College District without regard to race, color,
religion, gender, national origin, age, disability, sexual orientation, gender identity, gender expression, or any other
basis prohibited by law.
-8-
Admissions Application
You must be in the presence of a Notary to complete and sign this Affidavit.
Before you complete this page see PAGE 2 question 4.
Before me, the undersigned Notary Public, on this day personally appeared
____________________________________________________________________ ,
known to me, who being by me duly sworn upon his/her oath, deposed and said:
1.
My name is _________________________________________________________.
I am _______ years of age and have personal knowledge of the facts stated herein and they
are all true and correct.
2.
I graduated or will graduate from a Texas high school or received my GED certificate in
Texas.
3.
I resided in Texas for 36 months leading up to graduation from high school or receiving my
GED certificate.
4.
I have resided or will have resided in Texas for the 12 months prior to the census date of the
semester in which I will enroll in _______________________________ (college/university).
5.
I have filed or will file an application to become a permanent resident at the earliest
opportunity that I am eligible to do so.
E-MAIL
How is my e-mail address used? E-mail is the colleges choice means of communication with
students. E-mail addresses, personal or district-provided, are used to notify students of official
pertinent information and information for activities in which the student has expressed interest.
In addition, all students are required to have an e-mail address on file at the
Admissions/Registrars office in order to utilize personalized online services (eConnect) that
require a login and to activate their online account. Having an e-mail address on record allows
students to use personalized services, such as registration, retrieval of grades and financial aid
disbursement information, reset password and receive confirmation of the change via e-mail, and
so forth. If students wish to use eConnect, a valid e-mail address must be on file at the
Admissions/Registrars Office.
What if I dont want to use my personal e-mail address? The college provides currently enrolled
students the ability to request a student e-mail address (NETMAIL) free of charge. Students may
request a NETMAIL e-mail address online through your eConnect account or contact the college
for more information.
Will my e-mail address be released or sold to a third party? E-mail addresses on file in the
Admissions/Registrars Office are considered part of directory information and may be requested
by outside sources under the Public Information Act, but are not sold to outside sources for
profit.
REGISTRATION
How can I register for credit classes? New-to-college students must participate in an orientation
session or see an advisor before registering for credit classes. Students who have attended
college before, who meet eConnect registration eligibility criteria, and who have a valid e-mail
address on file at the Admissions/Registrars Office, may register online through your eConnect
account. All other students may register through the Counseling/Advising office at the college.
PROTECTION OF INFORMATION
Our college privacy commitment is based on two simple ideas. We promise to:
Comply with all the applicable local, state and federal laws and regulations
Protect your privacy while still offering relevant, personalized service
Students may request that their directory information, including e-mail address, be protected to
prevent the release of information to outside sources by submitting a request online to the
Admissions/Registrars Office.
eConnect has carefully combined the very best security software and systems at every level to
ensure that the information entrusted to us is not intercepted or abused. Industry standard
technologies like SSL (Secure Socket Layers) are used to protect credit card numbers, e-mail
addresses and zip codes so they cannot be read as they travel over the Internet.
Brookhaven College
3939 Valley View Lane
Farmers Branch, TX 75244
972-860-4883
www.bhc.dcccd.edu/
Eastfield College
3737 Motley Drive
Mesquite, TX 75150
972-860-7167
www.efc.dcccd.edu/
El Centro College/BPI
801 Main Street
Dallas, TX 75202
214-860-2000
www.ecc.dcccd.edu/
Richland College
12800 Abrams Road
Dallas, TX 75243
972-238-6100
www.rlc.dcccd.edu/
Dallas Colleges
Online