To qualify for Early College, a student must be at least 16 years of age and must receive approval from their
high school counselor. The age requirement may be waived if their parent and their high school counselor
believe the student is ready to be successful in the NHTI course. Please fill out this form and submit the signed
and Early College Registration forms to Mark Bograd, Coordinator of High School Outreach or Registrar’s
Office in Sweeney Hall located on the NHTI campus. .
Student Information:
Last Name: First Name: MI:
Date of Birth: / / Home Phone: Email:
School Name: __________
_______________
School Counse
lor: _______________________ Grade: ______
NHTI Semester to attend: Fall Spring Summer Year:
School Counselor recommended courses (Subject, course #, and title, e.g. ENGL101C English Composition):
1. _________________________________________________________
2. _________________________________________________________
High School Counselor Approval:
1. I have reviewed the student’s academic transcript and recommend Early College enrollment in the
courses listed above.
2. I have verified that the NHTI courses selected will also satisfy a high school requirement or an
elective course.
3. I confirm that the student is at least 16 years of age or if under 16 years of age, I agree that
_____________________ is prepared to be successful in the above NHTI courses.
_________________________________ ___________
Signature of School Counselor Date
Parent/Guardian and Participating Student Approval:
1. The undersigned parent/guardian hereby grants permission for the participating student to enroll in the courses
listed above at NHTI. We confirm that the student is at least 16 years of age, or if under 16 years of age, we
agree that ___________________________is prepared to be successful in the above NHTI courses.
2. We understand that the coursework has college level content, which may include mature material.
3. We understand and agree that the college will treat the participating student as an adult, and that there
will be no supervision or transportation provided for students before or after class.
4. These courses are for college credit and will remain on the student’s permanent college record.
5. We understand that we are responsible to pay the cost of each Early College course upon registration, and
are responsible for the cost of books and materials for the course.
___________________________ ______ __________________________________________ ________
Signature of Participating Student Date Signature of Parent or Guardian (if the student is under 18) Date
NHTI, Concord’s Community College
31 College Drive,Concord, NH 03301
Mark Bograd, Coordinator of High School Outreach (603) 230-4029
Registrar’s Office (603) 230-4014 – Fax – (603) 230-9314
NHTI, Concord
s Community College
Early College Permission to Enroll Form
click to sign
signature
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click to sign
signature
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click to sign
signature
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