Dual Enrollment Program - ACKNOWLEDGEMENT/AUTHORIZATION FORM
ID#: Unweighted High School GPA: _________
Name: ____________________________________________________________________________________
First Name Middle Initial Last Name
Dual Enrollment High School: _____________________________________________________________
Email Address: _______________________________________ Phone Number: (_______) ______-__________
STUDENT ACKNOWLEDGEMENT
_It is my responsibility to register online each semester to receive college credits for classes. I will register by the
deadline set each term.
_I understand I will be enrolling in a college-level class that will require rigorous academic work and I will be graded on a
college-level grading standard. I understand that all college coursework and grades become a permanent part of my
official college academic history and transcript.
_I understand I will need written permission from the High School Liaison in order to withdraw from a Dual Enrollment
course. I can only withdraw from a course on or before the deadline set each term. I understand I will still be responsible
for the tuition fee of the course, as well as, the withdrawal fee.
STUDENT signature: _______________________________________________ Date: _____/_____/______
PARENT/GUARDIAN ACKNOWLEDGEMENT
_I give my child permission to participate in Dual Enrollment courses, listed above, from Saint Thomas University,
offered at my child’s high school.
_I understand that my child’s St. Thomas University account will be assessed tuition on a per credit basis ($60/credit) at
the dual credit rate and fees (Ex: 3 credit course = $180), and that tuition and fees must be paid by the deadline set forth
each semester, or a late fee may be charged.
PARENT/GUARDIAN name (please print): ___________________________________________________
PARENT/GUARDIAN signature: ________________________________________________ Date: _____/_____/______
High School Liaison Signature: ________________________________________
I certify that this student meets the criteria to take Dual Enrollment courses, and that he/she is a high school
student and has a 3.0 or better unweighted grade point average on a 4.0 scale.
