Alma College Application for Dual Enrollment
Course(s) Requested:
Course Number w/Section & Title: ________________________________________________________________________________
Instructor Signature _______________________________________________________________
Course Tuition $_____________ Course Fee(s) $___________ Course Meeting Days__________ Meeting Times______________
Subject to Change Subject to Change
Course Number w/Section & Title: ________________________________________________________________________________
Instructor Signature _______________________________________________________________
Course Tuition $_____________ Course Fee(s) $___________ Course Meeting Days__________ Meeting Times______________
Subject to Change Subject to Change
Billing Information (must be completed by the Sponsoring High School)
Billing Option A. Student may register for class(es) of his/her choice, district will pay tuition and fees not to exceed
$ _________________. Billing should be directed to:
______________________________________________________________ __________________________
School District Phone
___________________________________________ ______________________________ _______________
Billing Address City Zip
_____________________________ ___________________________________________ _______________
Principal Name School Official Responsible for Billing Date
Billing Option B. Student may register for class(es) of his/her choice, tuition and fees are the student’s
responsibility.
High School Authorization (please read and sign below)
Signature of School Principal is necessary even if the school district is not paying. Signature indicates that a designated school
district representative has determined the student is eligible for dual enrollment, and has discussed and completed the Dual
Enrollment Application form with the student, and the school district grants approval. Nonpublic school administrators will also
need to discuss with the student the tuition and fee responsibility for courses not covered by the Michigan Department of
Education (MDE). The student will be held accountable for tuition and fee costs if the school district or MDE rejects the student’s
billing request. Home-schooled parents should sign here.
**Principal Signature:_________________________________________________ Date:_____________________
Parent/Guardian Financial Guarantor Authorization (please read and sign below)
The student - or parent if the student is a minor - assumes full responsibility for the payment of tuition and fees that are not paid
by the school district or the Michigan Department of Education (MDE). If the student is enrolled in classes that are not approved
by and paid for by the school district or MDE, the student/parent shall be responsible for the payment of 100% of all tuition and
fees. In the event the bill is unpaid and it is sent to a collection agency, student - or parent if student is a minor – agrees to
reimburse Alma College the fees of any collection agency, which may be based on a percentage at a maximum of 50% of the
debt and all costs and expenses, including reasonable attorney fees we incur in such collection efforts.
**Parent/Guardian Signature:____________________________________________ Date:____________________
Applicant Verification (please read and sign below)
I certify that I answered all questions on this application truthfully, and that I have read and understand the information. I will take
responsibility to understand and comply with Alma College policies and procedures. I also understand that incorrect or
incomplete information by me may result in delay, denial, or withdrawal of admission, financial assistance and continued
attendance. I have read and understand the requirements and responsibilities stated on the Alma College Dual Enrollment
Admissions and Registration Instructions page in this application packet. Student signature, or parent/guardian if student is
a minor, authorizes communication between parent/guardian, Alma College, and release of a transcript to the student
and sponsoring high school upon completion of the course.
**Student Applicant Signature:__________________________________________ Date:_____________________
**Parent/Guardian Signature:___________________________________________ Date:_____________________
Alma College Registrar Signature: ___________________________________________ Date:______________________
*The use of this information will comply with all government regulations prohibiting violation of privacy rights.
Office Use Only – Processed by________________________ Date__________________________ AC ID_______________________________
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