Dual High School Enrollment
Section I: To be completed by student.
Semester: Winter Spring Summer Fall Year:
Name: Today's Date:
Last First M.
Address: ____________________________________________________________ Birth date: / / Age:
City: State: _______ Zip: Phone # :
Mission College ID Number: Social Security # :
(Highly Recommended but Optional)
Name of High School: Grade: 11
th
12
th
(Circle One)
Student signature: Date:
Section II: High School Principal / Designee.
(Note: See next page for College policies and High School’s responsibility regarding course
recommendation.)
A maximum of 3 courses not to exceed 8 units is permitted for each term.
Physical Education and Courses numbered 900 (basic skills) and above are not available for High School Students
Course Number:
Course Name:
Number of Units:
Section Number:
Course Number:
Course Name:
Number of Units:
Section Number:
Course Number:
Course Name:
Number of Units:
Section Number:
Registration Restricted to the above courses only
I certify that the above recommended number of units are based on the student’s ability to benefit from “advanced
scholastic or vocational work.”
I certify that this student’s recommendation for enrollment to Mission College does not exceed the 5% statutory limit, as stated on the
reverse side of this form.
I certify that I am the High School Principal / Designee, and authorized to sign this form.
Authorized School Official:
Title:
High School Principal / Designee (PRINT Name)
Date: Contact phone #:
Signature
Section III:
Parent / Guardian Consent. (Required when the student has not graduated from high school and under the age of 18)
Note: Please read the ParentsExpectation and Responsibilities section found on back of this form, before signing.
I have read the Parents’ Expectations and Responsibilities section on back of this form, and I understand my parental responsibility.
I certify that the High School Principal/Designee named above is my child’s school/district authorized representative.
In case of a medical emergency, please provide first aid or send my child to an emergency facility. I acknowledge that Mission
College cannot assume responsibility for the payment of expenses incurred.
Parent / Guardian Name & Signature: Date: ____________________
(Print Name / Signature)
NOTE: Please make a copy of completed forms for your records before submitting them to the college.
Office Use Only: Staff: ____________ Pre-Req: _______________ Reg Date: _____________ Time: __________
Comment:
Signature: Date:
Rev: A&R 12.14.16
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Section I. Student Information / Directions:
1. Apply for AdmissionApplication for Admission. Go the Mission College home page, www.missioncollege.edu, and click on the Apply Now link.
High school students must apply online if 16 years old or older.
2. Complete the Mission College Dual Enrollment Form, http://missioncollege.org/admissions/forms.html.
3. Submit completed form with:
a. All required signatures
b. Copy of current government-issued picture ID to confirm identity.
4. Some courses have prerequisites, a course skill which is required before entrance into a particular course. Please see a Counselor to review your high school
transcripts and determine if the prerequisite has been met, or an assessment test is required.
(Student ID # required to meet with a Counselor or take an assessment test).
5. High School student registration occurs three (3) weeks prior to the beginning of the semester/session. All high school students are required to submit their
completed enrollment documents in-person to the Office of Admissions & Records, Main Building, E1-501 during regular business hours.
After your registration request is processed, Staff will communicate your registration status directly to you or you may check your registration status
online via the My Mission Portal link on the home page, www.missioncollege.edu
.
You may only register for courses that have been approved by your high school principal or designee. No substitutions unless approved.
o If class is full, you may be waitlisted for the next available open seat in the class. An email will notify you of your ability to register into the
class. Once email is received, you have 3 business days from the original “send” date and you must go to the Admissions & Records office to
register into that waitlisted class. Otherwise, once the 3 business days have passed, the seat is offered to the next student on the list.
A maximum of 3 courses not to exceed 8.0 units (including waitlisted courses) is permitted for each full term (including Summer or Winter
sessions).
Students who miss the first day of class
may
be dropped from the class. However, it is your responsibility to drop classes by the published deadline
should you choose to no longer attend the class(es). (Go to the Admissions & Records Office to formally withdraw from your classdo not rely
on the instructor or any other process.)
6. If an assessment test is required, please go to the Assessment Center (E1-101), after receiving your official Mission student ID. Placement tests are computerized
and results are available immediately following the test.
7. Review the Schedule of Classes (www.missioncollege.edu, “Schedule & Catalog”) to ensure you meet all Academic Deadlines.
8. Students are expected to conduct themselves in a responsible college-environment manner see “Code of Student Conduct” (www.missioncollege.edu,
“Schedule & Catalog”).
Section II. Responsibilities of High School Principal, Counselor or Advisor. Please read before recommending courses:
The concurrent enrollment of students may be limited, per Title 5 / SB 338, whereby the “recommendation of this pupil will not result in a recommendation for
more than 5% of the total number of pupils who completed that grade immediately prior to the time of recommendation.” Students must be eligible for
college
level courses
, (e.g., Intermediate Algebra, or English 1A). Courses with 900 numbers (basic skills), and PE courses are NOT available for high school students.
1. Recommend only those course(s) that the student is ready to handle academically, emotionally and socially.
2. Remind the student and the parents that all classes are taught at the college level and pace, and that student confidentiality regulations apply.
3. A maximum of 3 courses not to exceed 8.0 units is permitted for each term, including Summer and Winter sessions.
Section III. Parents’ Expectations and Responsibilities:
1. Ensure that the student’s maturity level and academic preparation are appropriate for the college-learning environment. The content in some classes may not
be suitable for minors.
2. The student must have access to a parent (e.g., cell phone) in case of emergency.
3. Be advised that concurrently enrolled students are treated like any other college student; therefore, written authorization from the student (student must
complete Mission’s authorization form and provide photo ID no exceptions) is required to conduct business on his/her behalf. (Faculty should not be
contacted directly by parents.)
NOTE: For safety and liability purposes, all students under 18 years of age will be identified to the Instructor.
Rev: A&R 12.14.16
Dual Enrollment Program Policies and Procedures