CONCURRENT ENROLLMENT
STUDENT, PARENT, AND COUNSELOR ACKNOWLEDGEMENT FORM
Please use black or blue ink when filling out this form
STUDENT APPROVAL
I, (please print first and last name) ___________________________________ understand the following:
______ I am enrolled in a college level class that will require rigorous academic work. This class demands
responsibility and maturity equal to that of a college level student.
______ I will be graded on a college level grading standard. Signing off on this page indicates the
decision to receive an NHCC grade for a concurrent enrollment class.
______ It is my responsibility to apply to the college and register for the class in order to receive college
credits for this class. I need to check in eServices to confirm that I am enrolled in the class.
______ I am responsible to official drop or withdraw from my class (in eServices) in the event I cannot
finish. If I fail to do so, I will receive a failing grade.
______ I will talk to my teacher, high school counselor, or my NHCC contact if I have any questions
about dropping or withdrawing from this class.
I have read and understand the above guidelines and agree to conduct myself accordingly.
High School: __________________________________________________________________________
Student Signature: ________________________________________________ Date: ________________
PARENT/GUARDIAN APPROVAL
I am authorizing the enrollment of the above student in the postsecondary course through the high
school's concurrent enrollment program. I understand that submission of this form indicates a decision
to have an NHCC grade issued for the course.
First Name: ________________________________ Last Name: _________________________________
Parent/Guardian Signature: _________________________________________ Date: ________________
HIGH SCHOOL COUNSELOR APPROVAL
I highly recommend and authorize the enrollment in the Concurrent Enrollment program for this
student. By signing, l certify that the student has met the eligibility requirements of this program,
including an overall GPA of 2.0, and a passing score on the 8th grade MCA's.
An official transcript is enclosed to document that this student’s overall GPA is: ____________________
Counselor Signature: ______________________________________________ Date: ________________
