Bay Mills Community College
Non-Public School Dual Enrollment Application
Dual Enrollment is available for online and campus classes. Students must be in 11
or 12
grade to be eligible and will be restricted to a limit of two courses per term or not more than 8
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*
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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