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CAREER AND COLLEGE PROMISE (Martin Community College)

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CAREER AND COLLEGE PROMISE
STUDENT ENROLLMENT VERIFICATION FOR NC PUBLIC SCHOOLS
9th and 10th Grader College Transfer Pathway Participation
Student Information
Last Name: First Name: MI:
Address:
DOB: Current Grade: Phone #:
Email:
School District:
High School:
PowerSchool #:
Student/Family Agreements
I am interested in enrolling in dual enrollment with the NC Community College System. My
participation aligns with my post-secondary plans. I will participate in advising so I understand
the potential benefits and also some of the potential challenges with enrolling in dual enroll-
ment courses.
Student Signature:
I understand that my child will receive academic advising from the high school and the com-
munity college. I give permission for my child to participate in the dual enrollment program. I
permit the college to communicate my student’s progress to the high school/district to support
my child’s success.
Parent/Guardian Signature:
Parent Name:
Best Email:
Best Phone:
Date:
Date:
Based on: NCGS 115D-20(4.a.3.II), Session Law 2019-185, Senate Bill 366 NCDPI April 2020
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YES NO
School-Level Eligibility Verification
Verification by Principal or Designee
Name: Date:
Signature:
Role:
Email:
FOR DISTRICT/SCHOOL USE
AIG Verification
Verification by Local AIG Coordinator (Applicable for LEAs and select Charters)
AIG Coordinator Name:
Email:
Signature: Date:
Student is identified at least as academically gifted in math and reading. [Per NCDPI, this also
satisfies English identification.]
FINAL DISTRICT/SCHOOL EVALUATION:
Student is approved to move forward to the local community college.
Student does not meet the eligibility verification criteria.
Date:
The student meets the eligibility requirements for CCP by demonstration of college
readiness in English, reading, and math on an approved assessment.
Academic advising has been provided by the high school.
Student has the maturity to support admission to community college.
Provide rationale for justification:
Based on: NCGS 115D-20(4.a.3.II), Session Law 2019-185, Senate Bill 366 NCDPI April 2020
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Name: Date:
Signature:
Role:
Email:
This form will be shared/reviewed with parents.
Decision shared with parents/guardian on .
By:
The student has been provided academic advising by the community college.
The student has the maturity to justify admission to the community college.
Provide rationale:
The student plans to enroll in the following College Transfer Pathway:
Based on: NCGS 115D-20(4.a.3.II), Session Law 2019-185, Senate Bill 366 NCDPI April 2020
FOR LOCAL COMMUNITY COLLEGE USE
Verification by CC President, Chief Academic Officer, or Chief Student Development Officer
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CAREER AND COLLEGE PROMISE (Martin Community College)

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Completed 29 January 2021

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