Apply BEFORE SUBMITING THE FORM BELOW, YOU MUST READ THE GUIDELINES AND FULL APPLICATION AND AGREE TO THEIR TERMS. YOU ALSO UNDERSTAND YOU WILL BE ASKED TO COMPLETE AND SIGN THE APPLICATION BEFORE BEING PROCESSED INTO RESIDENCY. Click Here To Read ApplicationDate Date Format: MM slash DD slash YYYY Name First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Phone*Referring Agency or Person:PERSONAL INFORMATION - ARE YOU......Select all that apply Incarerated On Probation On Parole Married Divorced Single Have Children Have Medical Insurance Employed On Disability Taking prescription medicationAnything else we should know?