Fillable F R A M level or Math courses (Fullerton College)

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F R A M level or Math courses (Fullerton College)

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Page 1 of 6 Updated 5/3/17
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321 E. Chapman Ave ∙ Fullerton, CA 92832-2095 ∙ (714) 905-5162
www.fullcoll.edu
BEFORE APPLYING FOR ADMISSION, PLEASE NOTE THE FOLLOWING:
F-1 and F-2 students may be eligible to enroll as a Special Admit student but will be
required to pay non-resident tuition. Please contact the International Student Center for
more information https://isc.fullcoll.edu/high-school-students/.
Special Admit students may not be enrolled in ESL, English or Reading courses below 100
level or Math courses below 40 level.
Part-time Special Admit students are required to pay the Health fee.
Full-time Special Admit students are required to pay the Health fee and enrollment fees.
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ENROLLMENT PROCESS:
Step #1 Apply for admission - www.fullcoll.edu
Step #2 Download and complete the Petition to Enroll as a Special Admit Student
Step #3 Complete Parts I – VII of the Petition to Enroll as a Special Admit Student in the
order of appearance.
□ Part I
Student Information: Complete and sign.
□ Part II
School Principal Sign-off Recommendation: For spring or fall.
Personnel who is signing the Part II must also have a Designated Signatory form
on file with the Fullerton College Admissions & Records office.
□ Part III
School Principal Sign-off Recommendation: For summer school only.
Personnel who is signing the Part III must also have a Designated Signatory form
on file with the Fullerton Admissions & Records office.
□ Part IV
Parent/Guardian Consent: Read and sign.
□ Part V
Counseling Department Clearance: Obtain clearance from Fullerton
College Counseling Department.
□ Part VI
Special K-8 Part-time Student Division Dean Approval: Complete if
applicable.
□ Part VII
College President Approval: Complete if applicable.
□ Complete the “Permission to Treat a Minor” form and return to Health Services.
Step #4 Prerequisite Clearance – all courses with prerequisites must be cleared the Counseling
Department prior to registration.
Step #5 Return completed petition to the Admissions & Records Office at admissions@fullcoll.edu
Step #6 Register for recommended classes through “myGateway”
Step #7 Pay all applicable fees
YOU ARE NOT OFFICIALLY ENROLLED UNTIL YOU HAVE FOLLOWED THE ABOVE PROCESS.
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Parental Advisory:
It is the parent or guardian’s responsibility to make arrangements for a Special Admit student to be picked
up from class/school in an emergency situation, class cancellation or if the class is dismissed early for
unforeseen circumstance.
Page 2 of 6 Updated 5/3/17
321 East Chapman Avenue
Fullerton, CA 92832-2095
www.fullcoll.edu
9200 Valley View Street
Cypress, CA 90630
http://CypressCollege.edu
(Formerly called the Bridge Program)
Concurrent Enrollment of Pupils in K-12 & Community College
Designed primarily though not exclusively for junior & senior high school students seeking an
enrichment opportunity in advanced scholastic or vocational work at
Fullerton College or Cypress College
North Orange County Community College District
Board of Trustees
Barbara Dunsheath
Molly McClanahan
Ed Lopez
Jeffrey P. Brown
Jacqueline Rodarte
Ryan Bent
Stephen T. Blount
Cheryl A. Marshall, Chancellor
JoAnna Schilling, President, Cypress College
Greg Schulz, President, Fullerton College
The North Orange County Community College District, in compliance with all applicable Federal and State laws, does not discriminate on the basis of race, color, national origin, ancestry, marital status, age,
religion, disability, sex or sexual orientation in any of its policies, procedures or practices. The District is also committed to maintaining campuses that are free of harassment, drugs and alcohol. A copy of the
District’s full policy on non-discrimination, sexual harassment, sexual assault treatment and counseling, and maintenance of a drug-free environment is available in the District Human Resources Office.
Page 3 of 6 Update 5/3/17
Cypress College and Fullerton College offer K-12 students an opportunity to enroll in
college courses as Special Admit Students. Enrollment is exclusively for advanced
scholastic or vocational work.
(In compliance with the California Education Code Sections: 48800 - 48802, 76001 and 76300)
Advanced Scholastic Work includes courses at the college level such as college calculus, chemistry, foreign
languages, geology, computer sciences, geography, psychology, sociology, history, humanities, the arts, and
appreciation courses. These courses should not be available at the high school and may not be courses
previously taken.
Vocational Work includes courses in a wide variety of occupational areas such as air conditioning,
construction, drafting, photography, printing, refrigeration, fashion design and cinema radio-television. These
courses should not be available at the high school and may not be courses previously taken.
Physical Education classes will be limited to 10% Special Admit Student enrollment for each section.
How do I enroll?
Complete and sign the Special Admit Student form. A new Special Admit Student form must be submitted
each term.
Complete a Cypress College or Fullerton College Application for Admission.
Complete MATRICULATION SERVICES ELIGIBILITY FORM and take to college counseling.
Take the Special Admit Student form to the Admissions Office at Cypress College or Fullerton College.
When all parts are completed, the Admissions Office will review your application and required documents and
will issue a permit to register.
F-1 and F-2 students may be eligible to enroll as a Special Admit student but will be required to pay
non-resident tuition. Please contact the International Student Center for more information
http://isc.fullcoll.edu.
Individuals who are not enrolled in a public school (home school students, private school students, and
persons under 18 years of age who are not enrolled in school) may be eligible to enroll. Such students must
contact the office of the college president for petition information.
What credit is granted?
Courses taken as a Special Admit Student are recorded on the college permanent record as collegiate credit in
the same manner as regularly enrolled college students. Credit may be given at the high school and may meet a
graduation requirement. The student should consult with the high school counselor.
How many courses may I take?
Special Admit Students may enroll in up to 11 units per semester as a part-time student or enroll into 12 or more
units as a full-time student.
May I take English, ESL, Math or Reading courses?
Special Admit Students may take college level English, ESL, Math or Reading courses. Such students must
meet the catalog stated prerequisites, if any, or demonstrate the necessary skills to be successful in such college
courses, as indicated through completion of placement tests required of all new students.
May I take Advanced Vocational Courses?
Special Admit Students may take advanced vocational classes if they meet the listed requirements/prerequisites
in the Cypress College or Fullerton College Catalog.
What are the costs?
All Special Admit Students are responsible for all college fees, including lab, health, and parking fees, as well as
the purchase of required textbooks for each course. Enrollment fees are waived for California resident Special
Admit Students in grades K-12.
What are other requirements?
Special Admit Students are required to have a “Permission To Treat a Minor” form on file with the college
Health Center prior to receiving health services (form is included in the packet).
College Policies:
Special Admit Students must adhere to all college policies on course requirements, attendance and any other
applicable policies and procedures including Student Code of Conduct. Students who enroll in classes other
than those approved via this document may be dropped from those classes. Student records are protected
under the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and
Accountability Act (HIPAA). No one (including parents and high school officials) may access confidential
information without a student’s written permission.
Page 4 of 6 Update 5/3/17
Part I - To be completed by Student (Required signatures MUST be obtained in sequence)
Please Print
Name: _____________________________________________________ Date of Birth: _________
Last First Middle
Address: ___________________________________________________ College/CCC I.D.#:________________________
City: __________________________________ Zip: _______________ Telephone: (____)_________________________
Present School: ______________________________ Current Grade Level: _____ Age: _____Cumulative G.P.A. _______
When do you expect to graduate from High School? Month____ Year____ Email Address ___________________________
___9-12 Enrolled in Public High School ___K-8 Enrolled in Public School (Part VI)
___9-12 Enrolled in Private School, Home School, ___K-8 Enrolled in Private School, Home School,
and persons under 18 years of age who are not enrolled in and persons under 18 years of age who are not enrolled in school
school (complete Part VII) (complete Part VI and VII) *K-8 Students skip Part II and III
I plan to enroll in Cypress College in the ____ Fall ____ Spring ____ Summer 20____
I plan to enroll in Fullerton College in the ____ Fall ____ Spring ____ Summer 20____
I understand and agree to follow all requirements as a Special Admit Student. I understand I may be dropped from
any course for failure to meet program requirements.
Student’s Signature: _______________________________________ Date: ______________________________
Part II – To be completed by School Principal (Fall or Spring)
This pupil would benefit from advanced scholastic or vocational work at the College.
Please indicate: □ Part Time 1-11 Units □ Full Time 12-15 Units School Board Approval □ Yes □ No
Courses: _________________________________________ ____________________________________________
Title Course # Title Course #
Print Name and Title: ______________________________________________ Telephone #: ______________________
Signature: _______________________________________________________ Date: ____________________________
Part III – To be completed by School Principal (Summer Only)
This pupil would benefit from advanced scholastic or vocational work at the College. My signature confirms the
recommendation and verifies that no more than 5% of each grade level of our students are participating as Special Admit
Students.
(A) Demonstrates adequate preparation in the discipline to be studied.
(B) Exhausts all opportunities to enroll in the same or equivalent course, if any, at his or her school of attendance.
(C) School Board Approval.
Courses: _________________________________________ ____________________________________________
Title Course # Title Course #
Print Name and Title: ______________________________________________ Telephone #: ______________________
Signature: _______________________________________________________ Date: ____________________________
Part IV – Parent’s Consent
I have reviewed the above and give my consent for my son/daughter named above to participate as a Special Admit Student
at Cypress College or Fullerton College as indicated. I understand that I need to provide my son/daughter with a consent
form for medical treatment and a copy of my driver’s license for health care service. I understand that my son/daughter’s
records cannot be released to me without written consent. The Family Educational Rights and Privacy Act (FERPA) and the
Health Insurance Portability and Accountability Act (HIPPA) affords students certain rights with respect to their education
records. These rights include the right to inspect and review the student’s education records within 45 days of the day the
University receives a request for access. Students should submit to the registrar, dean, head of the academic department, or
other appropriate official, written requests that identify the record(s) they wish to inspect).
Parent or Guardian’s Signature: ___________________________________________ Date:_________________________
Petition to Enroll as a Special Admit Student
at Cypress College or Fullerton College
(In compliance with the California Education Code Sections: 48800 - 48802, 76001 and 76300)
Page 5 of 6 Update 5/3/17
Part V – All students must complete MATRICULATION SERVICES ELIGIBILITY FORM and take
to college counseling.
College Counselor’s Signature: ____________________________________________ Date:_________________________
Part VI - Special K-8 Part-time Student
Students in this population need to make an appointment with the respective Instructional Dean (see list below) to determine:
(1) age appropriateness for the desired course, (2) completion of a specified grade level, (3) demonstrated eligibility for
instruction using assessment methods and procedures established pursuant to Chapter 2 (commencing with Section 78210)
of Part 48 and regulations adopted by the Board of Governors of the California Community Colleges.
Courses: ________________________________________ ______________________________________________
Title Course # Title Course #
Dean’s Signature (1) _____________________________Division_______________________________Date___________
Dean’s Signature (2) _____________________________Division_______________________________Date___________
Part VII – Students enrolled in a Private School, Home School, and persons under 18 years of
age who are not enrolled in school.
Courses: ________________________________________ _____________________________________________
Title Course # Title Course #
College President’s or Designee’s Signature: ________________________________ Date:__________________________
Fullerton College Divisions
Business & Computer Information Systems
Interim Dean, Carlos Ayon
Phone: 714.992.7033
Counseling & Student Development
Dean, Jennifer Labounty
Phone: 714.992.7085
Fine Arts
Dean, John Tebay
Phone: 714.992.7035
Humanities
Dean, Dan Willoughby
Phone: 714.992.7037
Library Technology
Dean, Dani Wilson
Phone: 714.992.7040
Mathematics & Computer Sciences
Dean, Mark Greenhalgh
Phone: 714.992.7042
Natural Sciences
Dean, Richard Hartmann
Phone: 714.992.7044
Physical Education/Athletics
Dean, David Grossman
Phone: 714.992.7046
Social Sciences
Dean, Jorge Gamboa
Phone: 714.992.7048
Technology & Engineering
Dean, Kenneth Starkman
Phone: 714.992.7052
Cypress College Divisions
Business & Computer Information Systems
Dean, Henry Hua
Phone: 714.484.7217
Fine Arts
Dean, Dr. Katy Realista
Phone: 714.484.7142
Health Science
Dean, Rebecca Gomez
Phone: 714.484.7285
Language Arts
Dean, Eldon Young
Phone: 714.484.7177
Science/Engineering/Mathematics
Dean, Richard Fee
Phone: 714.484.7153
Social Science
Dean, Lisa Gaetje
Phone: 714.484.7185
Vocational
Dean, Steve Donley
Phone: 714.484.7231
Counseling & Student Development
Interim Dean, Flor Huerta
Phone: 714.484.7334
Page 6 of 6 Update 5/3/17
CONSENT TO TREAT MINOR PATIENT
California law requires the consent of a parent or legal guardian for medical care of persons under eighteen
(18) years of age who are not emancipated. If your dependent is not emancipated and is a student at
Fullerton College, or attending a program at Fullerton College, the information below must be completed
before treatment of your minor can begin. Check Semester Attending: Fall Spring Summer
North Orange County
Community College
District
Student Health
321 E Chapman Ave.
Services
Fullerton, CA 92832-2095
Phone 714-992-7093
Fax 714-992-9923
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