Fillable CONCURRENT ENROLLMENT PERMISSION FORM (Butte College)

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CONCURRENT ENROLLMENT PERMISSION FORM (Butte College)

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CONCURRENT ENROLLMENT PERMISSION FORM
School Relations
schoolrelations@butte.edu
530.895.2511 Phone
530.895.2962 Fax
Revised 09/23
_____________________________
Butte College Student ID Number
The completion of this form is required for any student that is currently enrolled in high school (or lower grade) and/or perusing a high
school diploma or equivalent. This includes students attending adult education programs.
NAME: BIRTH DATE:
EMAIL: PHONE:
CURRENT SCHOOL OF ATTENDANCE:
PROPOSED COURSES (Registration and enrollment will be restricted to the courses listed below:)
*Check the corresponding number(s) to indicate which criteria apply to each proposed course.
1. The course is required for the continued advancement of the student’s educational program.
2. The course enhances the student’s program of study as it relates to his/her educational goals.
3. The course enriches the student’s educational experience in ways not available within the District’s curriculum.
PRESENT GRADE LEVEL IS (Check One): K-8___ 9___ 10___ 11___ 12___ Adult Education ___
ENROLLMENT IS FOR (Check One): Fall___ Winter___ Spring___ Summer___ 20
Check here if currently eligible for special education services and/or accommodations.
Principal’s Acknowledgement, Recommendation & Certification of Courses: I certify that the above student is attending a
minimum day at my school, has adequate preparation for the above recommended course(s), and has exhausted all opportunities to
enroll in an equivalent course(s) in my school. I further certify that not more than five percent of the students of any one grade level will
be recommended for concurrent enrollment for summer term as mandated under Ed Code Section 48800
.
We consent to the above recommendation:
K-12 PRINCIPAL OR ADULT ED. MANAGER SIGNATURE: DATE:
K-12 COUNSELOR SIGNATURE: DATE:
PARENT/GUARDIAN SIGNATURE: DATE:
(Required if student is under the age of 18)
I authorize Butte College to release transcripts to the above-mentioned school:
STUDENT SIGNATURE: DATE:
DATE: APPROVED___ DENIED___ BUTTE COLLEGE REPRESENTATIVE SIGNATURE:
Course Number
(e.g. CSL 20, LM 40)
Units
*Criteria/
Rationale
(See Below)
K-12 Counselor
Approval
(Initials)
Butte College
Approval
(Initials)
EDUC 310 (Tutoring Service)
0
1 2 3
1 2 3
1 2 3
1 2 3
1 2 3
1 2 3
1 2 3
CONCURRENT ENROLLMENT PERMISSION & REGISTRATION PROCESS
1. Consult with your parent/guardian(s
), and/or your school counselor/principal and/or adult education manager to see if
you’d be a good candidate.
2. Apply online at http://www.butte.edu/admissions/apply.html It is recommended that you do not use your high school
email address when creating your account.
3. Math Placement: Concurrent enrollment students are eligible for Math 4, 5, 11, 18, 110, 116, 118, and 124. If
wanting to enroll in Math 12, 13, 20, 26 or 30 you must attach a high school or college transcript to the Concurrent
Enrollment Permission Form showing that the prerequisite has been met. Visit www.butte.edu/assessment/ to review
the math prerequisites.
4. English Placement: Concurrent enrollment students are eligible for English 2 or 3. We recommend you visit
www.butte.edu/assessment/ to review your options.
5. Prerequisites: Many courses offered through Butte College have some type of prerequisite. These are used to
establish and student’s readiness for the content to be covered within a course. A list of prerequisites can be found at
www.butte.edu/assessment/
6. Complete and Submit the Concurrent Enrollment Permission Form
Forms are available at www.butte.edu/services/highschool/concurrentenrollment
Consult with your school counselor/principal or adult education manger to select courses and obtain appropriate
signatures. It is advisable to select alternate courses in the event that the courses you select are full. Completed forms
can be submitted by the posted deadline the following ways:
• Fax to (530) 895-2962
• Scan/Email to schoolrelations@butte.edu
7. Registration: Once you have received confirmation that your permission form has been processed, proceed with
your registration via Butte College’s online MyBC portal. View the Butte College website to obtain the date and time for
your registration. Concurrent enrollment is limited to 11 units maximum in the Fall and Spring terms, 10 units
maximum in the Summer term, and 4 units maximum in the Winter term.
8. Fees: Enrollment and service fees are waived for concurrent enrollment students. Course material fees and textbooks
are not currently waived and may be an additional charge.
9. Attending Class: Students are responsible for complying with the rules and regulations of the college and follow the
Butte College academic calendar.
10. Transcripts: At the end of each term official transcripts will be mailed to your school for evaluation. If you would like
to request transcripts for your personal use complete a Transcript Request Form at www.butte.edu/admissions
CAMPUS, FEDERAL AND STATE REGULATIONS FOR CONCURRENT ENROLLMENT
• T
he Family Educational Rights and Privacy Act (FERPA) protects privacy of a student’s educational records by
placing limits on whom may have access to the records, what information may be shared or disclosed, and how that
information may be used. Butte College complies with FERPA and has strict policies and procedures in plac
e
gov
erning student records. Because Concurrent Enrollment students are considered college students (even if
underage), Butte College does not permit access to their educational records or disclose information to anyone
(
including parents/guardians).
• T
he law limits the number of concurrent enrollment students enrolled in each section of a physical activity class.
Approval for concurrent enrollment in a physical education class does not guarantee you will be selected to enroll i
n
t
hat class.
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CONCURRENT ENROLLMENT PERMISSION FORM (Butte College)

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Completed 2 February 2021

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