DUAL ENROLLMENT
REGISTRATION FORM
(All fields must be completed and form submitted prior to each registration term.)
Student Name__________________________________________________________ GSCC ID (A#) _______________________
Name of High School_____________________________________________________ Grade Level________________________
Registration Term_________________ Year_____________
(Spring/Summer/Fall)
List approved courses below. Courses should be selected by the student in collaboration with the High School Counselor and College Advisor.
GSCC Course(s) Requested
CRN #
Credits
High School Equivalent Course(s)
Unit Credit
Notes:
Developmental courses (those numbered below 100) and physical education courses are not eligible.
Students must meet all applicable pre-requisites and testing requirements prior to enrolling in courses.
Gadsden State reserves the right to cancel courses due to low enrollment, and enrollment in selected courses is not guaranteed.
Student Signature*________________________________________________________ Date___________________________
*By signing, I agree to be registered for the above courses and agree to all terms and conditions within the GSCC dual policy.
Counselor Signature:_______________________________________________________ Date___________________________
Information Verified and Entered by:______________________________________ Test Scores Verified in System: ____________
Admissions Office | P.O. Box 227 Gadsden, Al. 35902-0227 | (256) 439-6910 | Fax (256) 549-8466 | admissions@gadsdenstate.edu
STUDENT INFORMATION
COURSE AND CREDIT INFORMATION
INTERNAL USE ONLY
APPROVAL
10/2019
Intended Program of Study_________________________________
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