Bay Mills Community College
Non-Public School Dual Enrollment Application
Dual Enrollment is available for online and campus classes. Students must be in 11
th
or 12
th
grade to be eligible and will be restricted to a limit of two courses per term or not more than 8
hours.
Part I: To be completed by the student’s parent or guardian (please print clearly)
Student’s full legal name: ________________________________________________________
Social Security Number: ____________________ Gender: ___________ Birthdate: __________
Street Address: _________________________________________________________________
City/State/Zip: ____________________________________ Phone: _______________________
E-mail Address: ___________________________________ U.S. Citizen: ____ Yes ____ No
Ethnic Group (This information is required by the federal government. Please check one).
____ White, non-Hispanic Origin _____ Black, non-Hispanic Origin _____ Hispanic
____ Asian or Pacific Islander _____ American Indian or Alaskan Native
____ Non-resident Alien/Canadian
Full Title of BMCC Desired Course/s *A complete listing is available at www.bmcc.edu*
Course No: __________________ Subject Code: _______________ Title: _________________
Course No: __________________ Subject Code: _______________ Title: _________________
Semester and year you wish to take this course: Semester ____________ Year _____________
Current Grade: ______________________ Expected graduation date: ________________
Please include Transcript for classes and GPA verification.
As the student’s parent/guardian, I give permission for my student to take the specific course/s at
BMCC. I accept responsibility for tuition and all fees on behalf of the student.
Parent’s/Guardian’s Signature: _______________________________ Date: ________________
Billing Address: ________________________________________________________________
Phone: ______________________________
Notice of Placement Test and Prerequisites
We require you take the COMPASS prior to signing up for classes. Other classes have one or more prerequisites. A
prerequisite is a course that must first be completed before the desired course can be taken. The BMCC Admissions
office or Registrar’s Office can tell you if the course/s you wish to take require placement tests or prerequisites.
Scheduling cannot be completed until the COMPASS test results have been received.
Return this form to: Admissions Office
Bay Mills Community College
12214 W. Lakeshore Drive
Brimley, MI 49715
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