Pima Community College-Desert Vista-STEM-SSS

Are you a U.S. Citizen or Permanent Resident?*

YesNo

Do you have a documented disability?*

YesNo

If yes, are you registered with the Access and Disability Resource Office (ADR)?*

YesNoIn Process

Are you a First Generation College Student?*

YesNo

A first generation college student is:

An individual neither of whose parents/guardians received a Bachelor's Degree;
OR
A student who, prior to the age of 18, regularly resided with and received support from only one
parent/guardian who did not receive a Bachelor's Degree.

Complete one section, based on information from the most recent tax year.*

I was an independent student (typically age 24 or older, married or emancipated; parental income is not reported on the FAFSA)I was a dependent student (younger than 24, unmarried or not emancipated; parental income is reported on the FAFSA)

Number of people in household*

Federal Taxable Income*

Taxable Income (NOT Adjusted Gross Income: Form 1040 line 15. If taxes were not filed, please report total income from all sources.

Student Name*

First NameLast Name

Student Signature*

Tax Year*

Number of people in household*

Federal Taxable Income*

Taxable Income (NOT Adjusted Gross Income: Form 1040 line 15. If taxes were not filed, please report total income from all sources.

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Signature*

Tax Year*

Independent Student Section

Dependent Student Section