Fillable Form 12: Campus Select ConcurrentEnrollmentCollegeNowAgreement

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Form 12: Campus Select ConcurrentEnrollmentCollegeNowAgreement

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  • 5 signatures
  • 10 check-boxes
  • 65 other fields

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File type: PDF

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Campus Select
ConcurrentEnrollmentCollegeNowAgreement
Student:Youhaveindicatedthatyouareinterestedintakingacourse/courses through FrontRangeCommunityCollege. Persons
under21yearsofagewhoareenrolledinthe9
th
–12
th
gradeinaschoo ldistric t a ndwhodemonst r a t eacadem i c preparednessareeligible
forConcurrentEnrollmentPrograms.ConcurrentEnrollmentstudentsearnbothhighschoolandcollegecreditforthesamecourse,and
thestudents’shareofcollegetuitionispaidbytheschooldistrictandtheCOFstipend.Studentsin12
th
grademayenrollincollege
basicskillscourses,ifapprovedbytheirschooldistrict.Highschoolstudentswhoareretainedforinstructionalpurposesbeyondthe
12
th
grademaynotenrollinmorethanninecollegecreditsconcurrentlyduringthefollowingyear.Toenrollinacourseataneligible
postsecondaryinstitution,astudentmusthavecompletedtheminimumcourseprerequisitesandallrequiredassessments.
SECTIONA:TobecompletedbytheStudent (IF PRINTING, PLEASE PRINT CLEARLY & USE BLACK OR BLUE PEN)
Name:
CollegeStudentID#S
Semester/Year
HighSchoolID#
Address City State_
CO
ZipCode
HomePhone Cell
GraduationYear
HighSchoolAttending:
DateofBirth
Test(s)youhavetaken: Accuplacer AC T SAT
NameofParent/Guardian
SECTIONB:Tobesignedbythestudentandthestudent’sparentorguardian
Attentionstudentandparentorguardian:Yoursignaturebelowindicatesthatyouwishtheabove‐namedstudenttoparticipatein
theConcurrentEnrollmentProgramandthatyouagreetothefollowing:
1.
ThestudentreceivedadviceandcounselaboutparticipatingintheConcurrentEnrollmentProgramfromhisorherhighschool.
2.
ThestudentmustapplyfortheCollegeOpportunityFund(COF)whenenrollinginanyConcurrentEnrollmentCourse.Thiscanbe
doneonlineathttps://cof.college-assist.org/orbyauthorizingthecollegetoapplyonthestudent’sbehalfontheonline
admissionsapplication.Thestudentorparent/guardianwillreceiveabill(andmaybesubjecttocollectionsattheendofeach
term)ifCOFisnotappliedtothestudent’scollegeaccount.
3.
ThestudentauthorizeduseofhisorherCOFstipendforalleligiblecreditsforthesemesterstatedaboveandallfuturesemesters.
College‐levelcreditsusedwillbedeductedfromthestudent’sCOFlifetimeaccount.
4.
Thestudentmustmeetthesameprerequisitesandcourseexpectationsasallothercollegestudentsinacourse,asnotedinthe
currentacademicyearcatalogandthecoursesyllabus.
5.
Thegradereceivedineachcoursewillappearonthestudent’sofficialhighschoolandcollegetranscripts.
6.
CollegecoursecreditsmaytransferincongruencewithColoradoGTPathwaysorarticulationagreementsifthestudentearnsa
“C”orbetterinthecourse.
7.
Ifthestudentseekstoadd,droporwithdrawfromacollegecourse,heorshemustmeetwiththeirhighschoolcounselor
andnotifythecollegeconcurrentenrollmentstaff.
8.
Ifthestudentwithdrawsfromacourseafterthecollege’sdropdeadline,thecollegewillrecorda“W”or“F”onhisorhercollege
transcript.
9.
Ifthestudentreceivesagradeof“F”,an“incomplete”,orwithdrawsfromacourseafterthecollege’sdropdeadline,the
studentandthestudent’sparentorguardianmayberequiredtopaytheschooldistrictforthetuitionitpaidthecollegeforthe
course.
10.
ThestudentmaynotenrollinacourseundertheConcurrentEnrollmentProgramunlessitfitswithhisorherIndividual
Career&AcademicPlan(ICAP/PEP).
11.
Onlycoursesthatapplytowardacollegedegreeorcertificate,or(for12
th
gradersonly)thatqualifyasbasicskillscourses,are
coveredundertheConcurrentEnrollmentProgram.
12.
ThestudentmaynotenrollinacourseundertheConcurrentEnrollmentProgramunlessitisapprovedbytheSchoolDistrict.
13.
IncompliancewiththeFamilyEducationalRightsandPrivacyAct(FERPA)of1974,thestudentgivesthecollegepermissionto
reportabsencesanddisciplina
ryissues,andtoreleasegrades,transcripts,in‐progressgrades
,classschedules,andbilling
information,asavailable,totheSchoolDistrictforthecoursescoveredundertheConcurrentEnrollmentProgram.
14.
AnyunresolvedbalanceofCOF,studentfees,and/ortuitionforclassesnotpaidbytheSchoolDistrict,alongwithapplicable
collectionfeeswillbetheresponsibilityofthestudentandparent/guardianpertheFRCCStudentPaymentAgreement.
15.
Bysigningthisagreement,studentandguardianconfirmthattheyhavereadandagreetotheFRCCStudentPaymentAgreement.
(www.frontrange.edu/payagree).Thepaymentagreementacceptancecoverstheperiodofregistration(semester/year)agreed
toonthisconcurrentenrollmentform.
IunderstandandwillabidebytheabovestatementsinthissectionB.
StudentSignature Date ParentorGuardianSignature Date
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signature
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signature
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StudentName
CHECKLIST
NewStudentsmusthavethefollowingtoenrollasastudentinacollegeclass:
CollegeAdmissionsApplication
COFVerification
QualifyingACT,SAT,orAccuplacerscores,ifapplicable.
ThisConcurrentEnrollmentCollegeAgreementformcompletedwithALLsignatures
Returningstudentmustcompletethisformandhavemetallcoursepre‐requisitestore‐enrollasaConcurrentEnrollment
student.
SECTIONC:Part1–StudentEligibility:
Thisstudentisunder21yearsofage.
Thisstudentiscurrentlyinthe
th
grade.
Thisstudentiseligibletoenrollinbasicskillscourses(ex:CCR,MAT050/055)(12
th
gradersonly).
SECTIONC:Part2–CourseSelection:Tobecompletedbystudent.Finalizedbyyourcounselor.
AttentionHighSchoolCounselor:
Yourinitialsnexttoacourseverifythatthecourseisincludedinthestudent’sICAP/PEP.
STUDENTSASID#:
(Tobecompletedbyyourschoolcounselororadministrator)
HighSch
oolCounselor/PrincipalSignature: Date:
SectionD:Part1–SchoolDistrictApproval
IfsignedbytheSuperintendentordesignee,theSchoolDistrictagreestopaythetuitionforeachcourseinitialed
above:
Title: Date:
ApprovedbytheSuperintendent(ordesignee)
Signed:
SECTIOND:Part2–Collegeapproval
ApprovedbyCollegeAdministrator
Signed:
Title: Date:
FallSemesterClassesApproved:
Subject Course
Number
Title Credit
Hours
Counselor
Initials
MAT 121 CollegeAlgebra(EXAMPLE) 4 ASW
TotalCreditsApprovedFallSemester:
SpringSemester/YearLongClassesApproved:
Subject
Course
Number
Title
Credit
Hours
Counselor
Initials
MAT 121 CollegeAlgebra(EXAMPLE) 4 ASW
TotalCreditsApprovedSpringSemester:
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Form 12: Campus Select ConcurrentEnrollmentCollegeNowAgreement

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Completed 9 February 2021

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