White District Office; Yellow High School; Pink Student Revised 10/14
Concurrent Enrollment Form
New students must complete the Admissions Application online at www.cochise.edu/apply.
Enrollment is limited to 12 credit hours. Students planning to take more than 12 credits at Cochise
College must see a Cochise College advisor or counselor.
Course prerequisites or placement score requirements must be met prior to registering for class(es).
This one-time consent form signed by a parent or legal guardian must be on file prior to registration.
STUDENT INFORMATION
SSN:
Cochise College Student ID #:
Date of Birth:
Last Name:
First:
M.I.:
Phone:
HS Graduation Date:
Student SAIS#: _______________
Meet with your high school counselor if you plan to use Cochise College courses towards your high school graduation.
PARENTAL CONSENT
The college learning environment encourages critical thinking and promotes contrasting perspectives of the
world. This environment is one of adult interaction where students will likely be exposed to concepts,
lectures, and materials that are generally focused toward adults and adult audiences, including unrestricted
internet access. I understand that no extra supervision is provided for minors before, during, or after class.
Registration Information:
Concurrently enrolled students establish a permanent college academic record that may be
required by future colleges or universities.
All students are expected to be in compliance with all current published college policies, rules, and
regulations.
I approve of my son/daughter taking courses at Cochise College. I understand that there are privacy
restrictions on my student’s records and I will be unable to obtain information or transcripts without their
written consent. In consideration for Cochise College allowing my child to enroll and attend classes, I
promise to pay tuition if my child fails to pay in a timely manner.
PARENT/GUARDIAN__________________________________________________ DATE__________________
I give my permission to Cochise College to release registration and grade information to my high school. In
consideration for Cochise College allowing me to enroll and attend classes, I promise to pay the required
tuition. I acknowledge that if I fail to pay tuition when requested, 1) I may be un-enrolled or otherwise dropped
from the class: and 2) Cochise College may refuse to give me my transcripts, or forward to other institutions,
including my high school or other colleges.
STUDENT______________________________________________________________ DATE_____________________
FOR OFFICE USE
TERM______________________________
SGASADD SAIS / SPAIDEN
DATE & INITIALS_____________________
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