CERTIFICATION OF HIGH SCHOOL PRINCIPAL AND DESIGNATION OF
SIGNATORIES FOR YUBA COMMUNITY COLLEGE DISTRICT 2020-2021
(Dual Enrollment for High School Students )
General Provision: The following high school principal certifies that the individuals identified below are designated signatories
.
This
approval form serves as authorization to act as his/her designee in matters relating to students’ enrollment in courses within the Yuba
Community College District. It is understood that instructors of record are legally prohibited from signing this form as the principal’s designee.
Summer Enrollment Provision: The principal also certifies he/she has made the determination that the recommendation of students will
not result in the enrollment of more than five (5) percent of the total number of students who completed that grade immediately prior to the
time of recommendation.
This portion to be completed by the high school principal (for signature, please use a blue/black pen or electronic signature).
________________________________________________
High School Name
__________________________________________
Principal's Name
________________________________________________
High School Mailing Address
_________________________________________
Principal's Signature
_______________________________________________
City State Zip
_________________________________________
Principal’s Email Address
__________________________________________
Principal’s Phone Number
Approved Designees (one designee is required, additional designees are optional):
________________________________________________
Name and Title of Designee A
__________________________________________
Signature of Designee A
________________________________________________
Email Address of Designee A
__________________________________________
Phone Number of Designee A
________________________________________________
Name of Designee B
__________________________________________
Signature of Designee B
________________________________________________
Email Address of Designee B
__________________________________________
Phone Number of Designee B
________________________________________________
Name and Title of Designee C
__________________________________________
Signature of Designee C
________________________________________________
Email Address of Designee C
__________________________________________
Phone Number of Designee C
If the above high school has more than three designees, please submit additional pages.
Please email the completed form to WCCadmissionsinfo@yccd.edu
(Woodland Community College areas) or YCAdmissions@yccd.edu (Yuba College areas).
