_________________________________ ________________________ _______________
Student’s Name GC Student ID Date of Birth
Applying For _______________ Semester: Fall Spring Summer I Summer II
Academic Year
STUDENT MAJOR: __________________________________________________ (majors on back)
ANTICIPATED TRANSFER INSTITUTION: _____________________________________________
STUDENT ACKNOWLEDGEMENT:
As a student, I have selected these courses for dual credit/early enrollment that have been approved by the local school district. I have
reviewed the admission requirements and transferability of courses taken at Galveston College with the college or university of my
choice as applicable. I further understand that I may be required to submit proof of vaccination against Bacterial Meningitis, as required
by Texas law. I grant permission to Galveston College to request my official high school transcript.
________________________________
Student’s Signature Phone Number
PARENT/GUARDIAN ACKNOWLEDGEMENT:
I, the undersigned parent/guardian of the student listed above, request that my child be permitted to enroll for the listed college
course(s).
________________________________
Parent/Guardian Name Parent/Guardian Signature
ENDORSEMENT BY SCHOOL OFFICIAL:
The student listed above is a high school student and is eligible to enroll for dual credit/early enrollment. I have reviewed the course(s)
listed above to be taken at Galveston College and grant permission for the student to enroll at Galveston College.
Authorized School Official Name Authorized School Official Signature
Approval for Galveston College Dual Credit/Early Enrollment Program:
____
Office of Admissions/Dual Credit Advisor Date
