Fillable CCAPMCAdmissionPetition - CCAP & Middle College Admission Petition

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CCAPMCAdmissionPetition - CCAP & Middle College Admission Petition

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Columbia College
College Career Access Pathway-CCAP/Middle College Admissions Petition
Name: Student SSN:
Last First MI
Phone: Birth Date: Grade Level:
Please indicate the Year & High School in which you are petitioning to enroll (a new petition is required
each academic year):
ACADEMIC YEAR: ____________________(i.e. 2018-2019)
School Name:___________________________
Desired CCAP/Middle College Courses
1._________________ 2._________________ 3._________________ 4._________________
Course Title Course Title Course Title Course Title
***Upon graduation, students must complete a NEW Columbia College online Admissions Application as a
First Time Freshman in order to no longer be considered a 9-12 (high school) student.
The student requesting advanced admission must meet the criteria set forth by the California Education
Code, Section 4, 48800, 48800.5, and 76001.
Eligibility Requirements
1. CCAP/Middle College admission is granted to students enrolled in the 9-12
th
grade, and who are at least 14
years of age prior to the start of term in which they are applying for, and who are enrolled at either
Summerville High School, Sonora High School, Bret Harte High School, or Calaveras High School.
2. The high school principal or authorized designee must sign this admission petition to certify the student is
prepared to take college level courses of a maximum of 15.0 units for CCAP students and 11.5 for
Middle College students per term, all of which are approved courses (State Ed Code 76001-d).
3. For those enrolled in the CCAP program, the district will pay all tuition and fees for the approved
courses above.
4. Middle College students are required to pay all health fees associated with the college per term, only
tuition is covered.
5. CCAP/Middle College students will receive a level 3* priority registration date and time (see Admissions
for more information).
Over
Documentation Requirements
Clear Form
High school students must submit the following to the Admissions Office:
1) The completed Admission Petition (once per year)
2) The Consent for Treatment of Minors Health form (once only)
3) The California Community College Promise Grant (once per summer)
SECTION 1: CERTIFICATION BY HIGH SCHOOL PRINCIPAL OR AUTHORIZED DESIGNEE:
I certify that the petitioner is prepared to undertake associate degree applicable credit coursework. I recommend that
he/she enroll in the above course/courses, not to exceed 15.0 units for CCAP and 11.5 for Middle College per
term.
Signature of high school principal or authorized designee Date
SECTION 2: CERTIFICATION BY HIGH SCHOOL PARENT AND STUDENT:
Parent AND student must sign the petition.
I certify that I have read the conditions of enrollment and that I will adhere to all college policies and
procedures:
Signature of student Date
SPECIAL NOTE: It is expected that all CCAP/Middle College students enrolling in Columbia College courses have
the maturity to function effectively on a college campus. No special arrangements for additional supervision of
underage students are available. College courses are designed for adult students. In a very small number of
disciplines, course content may be unusually frank in order to deal with scholarly discussion of behavioral, artistic,
human, or other issues. Unlike public schools, colleges do not contact parents in advance to inform them of these
matters. Parents are hereby notified that it is their responsibility to ensure that their child is able to handle the
college environment, as well as the content of the course in which he/she enrolls. Although CCAP/Middle College
students may be minors, they are entitled to all of the privacy rights of a college student. Therefore, any
information regarding attendance, grades, behavior, etc., cannot be shared with the parent or legal
guardian. Student account information including attendance and grades can be accessed through
connectColumbia.
Signature of parent/legal guardian Date
Additionally, I understand that my son/daughter has been assigned a Columbia College e-mail account.
Office Use Only:
PERC Health BOGW
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CCAPMCAdmissionPetition - CCAP & Middle College Admission Petition

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Completed 11 March 2020

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