RESIDENCY STATUS
NEW HAMPSHIRE RESIDENCY (See NHTI.edu/paying-for-nhti/tuition-fees/)
Date student moved to N.H. _____________________________ OR I have always lived in New Hampshire
Month/Year
IN-STATE TUITION FOR OUT-OF-STATE STUDENTS (ISTP50)
The In-State Tuition Program allows for out-of-state students whose town or city borders are within or contiguous to a
50-mile radius of the NHTI campus to receive in-state tuition. Effective Fall 2017.
I am a resident of ___________________________________________ and request to be considered for ISTP50.
Town/City State
NEW ENGLAND REGIONAL STUDENT PROGRAM (NERSP) APPLICANTS (See NHTI.edu/paying-for-nhti/tuition-fees/
new-england-regional-student-program-nersp/)
NERSP enables a resident of a New England state to enroll in a public college or university in the six-state region at re-
duced rates for all students for all of NHTI's degree and certicate programs.
For New England residents who wish to be considered for NERSP:
I am a resident of _____________________________________________ and request to be considered for NERSP.
Town/City State
TO BE SIGNED BY ALL APPLICANTS
The information provided by the applicant on this admission application form shall be held condential to the extent
determined by Federal law and NHTI policy. NHTI, Concord’s Community College, reserves the right to deny admission
to any applicant, who, in the judgment of College ofcials, does not qualify for admission. NHTI also reserves the right to
require withdrawal of a student who does not satisfy the ideals of citizenship, character, or scholarship.
In accordance with the terms and conditions set forth in its publications, and if accepted, I agree to abide by the rules and
regulations set forth in the publications and in the student handbook. I also agree that NHTI has permission to use any
college-sponsored pictures in which any likeness appears. I certify that when I begin college at NHTI, I will have graduated
from high school, received my high school equivalency diploma, or completed my high school education. I certify that I have
read and agree with the above, and that all information provided herein is true and complete.
Signature of Applicant ________________________________________________________________________________ Date ____________________
Signature of Parent or Legal Guardian
(if student is under 18 years old) ______________________________________________________________________ Date ____________________
Statement of Nondiscrimination
NHTI is committed to creating and maintaining a positive and productive learning environment for students, a professional setting for its employees, and a
community atmosphere grounded in mutual respect, dignity, and integrity. In light of these objectives, NHTI prohibits all manner of discrimination in the
administration of its employment programs and practices on the basis of unlawful criteria including race, color, religion, national or ethnic origin, age, sex,
sexual orientation, marital status, disability, gender identity or expression, genetic information, and veteran status, as dened under applicable law. This
statement is a reection of the mission of NHTI and refers to, but is not limited to, the provisions of the following laws, as amended: Title VI and VII of the
Civil Rights Act of 1964, as amended, the Age Discrimination Act of 1967 (ADEA), Title IX of the Education Amendment of 1972,Section 504 of the Reha-
bilitation Act of 1973, the Americans with Disabilities Act of 1990 (ADA), Section 402 of the Vietnam Era Veteran’s Readjustment Assistance Act of 1974,
NH Law Against Discrimination (RSA 354-A), Genetic Information Nondiscrimination Act of 2008.
Inquiries regarding discrimination may be directed to Trish Loring, NHTI Title IX and Civil Rights/Equity Coordinator, SC227 Student Center, NHTI –
Concord’s Community College, 31 College Drive, Concord, NH 03301-7412, 603-271-6484 x4184; email: tloring@ccsnh.edu; or Sara A. Sawyer, Director
of Human Resources for the Community College System of NH, 26 College Drive, Concord, NH 03301, 603-230-3503. Inquiries may alsobe directed to
the U.S. Department of Education, Ofce of Civil Rights, 8th Floor, 5 Post Ofce Square, Boston, MA, 02109-4557, 617-223-9662,fax: 617-223-9669,
TDD:617-223-9695, or email: OCR_Boston@ed.gov; the N.H. Commission for Human Rights, 2 Chenell Drive, Concord, NH 03301, 603-271-2767, fax:
603-271-6339; and/or the Equal Employment Opportunity Commission, JFK Federal Building, 475 Government Center, Boston, MA, 02203, 617-565-
3200 or 1-800-669-4000, fax: 617-565-3196, TTY: 617-565-3204 or 1-800-669-6820. This publication is available in alternate formats upon request.
Please contact the Ofce of Disabilities Services at 603-230-4000 x4117 or x4432; tty 603-223-2316.
NHTI–Concord’s Community College is one of seven colleges in the Community College System of New Hampshire.
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