Dual High School Enrollment
Section I: To be completed by student. Semester: Winter Spring
Summer
Name:
/ /
Age:
Fall Year:
Mission College ID #:
Name of High School:
Grade: 9
th
10
th
11
th
12
th
Student signature:
Date:
Section II: 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.
I
n case of a medical emergency, please provide first aid or send my child to an emergency facility. I realize that Mission College cannot
assume responsibility for the payment of expenses incurred.
Parent / Guardian Name & Signature: Date: ____________________
(Print Name / Signature)
Last First M.
Address: ____________________________________________________________ Birth date:
State:_______ Zip: Phone # : City:
Email Address:
Admissions & Records Use Only:
Date Received: ____________ Date Validated: ____________ Assigned Registration Date: __________________
By: ___________________
High School Use Only (optional): High School Credit: College Credit:
A&R 3/2020
Section III: 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:
Registration Restricted to the above courses only
(# of units) are based on the student’s ability to benefit from “advanced scholastic or
Course Number :
Course Name:
Number of Units:
Section Number:
I certify that the above recommended
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:
High School Principal / Designee (PRINT Name)
Date:
Title:
Contact phone #:
Signature
NOTE: Please make a copy of
completed forms for your records before submitting them to the college.
SUBMIT FORM
click to sign
signature
click to edit
Section I.A. Student Information / Directions:
1. Apply for Admission Visit apply.missioncollege.edu to create an account with OpenCCC Apply and apply to Mission College.
2. Students wanting to take Math or English at Mission College must visit placement.missioncollege.edu to determine the most appropriate
placement using our Placement Assistance Tool.
3. Complete the Mission College Dual Enrollment Form with all necessary signatures and submit the form either via email to
dual.enrollment@missioncollege.edu or in person at Admissions & Records, SEC 118 at Mission College.
a. Please allow at least 10 business days prior to the start of the Dual Enrollment registration period for processing time. All forms
received after this date will be processed as quickly as possible in the order they are received.
b. Students registering in person must bring a current picture ID to confirm identity.
4. Activate your WVMCCD email. All correspondence once you have registered for classes will be sent to this address.
5. Clear any prerequisites for the courses you wish to take prior to your registration date. If you feel you have met the prerequisite, please
complete the Prerequisite Clearance.
6. After your Dual Enrollment Form is processed, staff will communicate your assigned registration date to you via email. You can check
your registration date and register for classes online via the My Mission Portal link on the home page, www.missioncollege.edu.
7. High school students are responsible for paying the Health Center Fee which can be paid via My Mission Portal or in person at the Office
of Admissions & Records in SEC 118.
Section I.B. Student Information- Additional Policies
1. Dual enrollment registration typically begins three (3) weeks prior to the starts of the semester/session. Exact dates can be found at
hs.missioncollege.edu.
2. All dual enrollment students are required to submit the Dual Enrollment Form either via email or in-person to the Office of Admissions &
Records at Mission College.
3. Students may only register for courses that have been approved by their high school principal or designee. All substitutions must be
approved by the high school designee and re-submitted through a new Dual Enrollment form to Admissions & Records.
4. If a class is full, students will be added to the waitlist for the next available open seat. Should space in the class become available, students
will be notified via their WVMCCD email and have 48 hours from the time the notification is sent to register either online or in person.
Once the 48 hours have passed if you have not registered, the seat will be offered to the next student on the list.
5. 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).
6. Kinesiology and 900-level courses are not eligible for Dual Enrollment.
7. Students who miss the first day of class may be dropped from the class. However, it is your responsibility to drop classes either online or in
person by the published deadline should you choose to no longer attend the class(es).
8. Review the Schedule of Classes (www.missioncollege.edu, “Schedule & Catalog”) to ensure you meet all Academic Deadlines.
9. Students are expected to conduct themselves in a responsible manner appropriate for the college environment. See Code of Student
Conduct (www.missioncollege.edu, “Schedule & Catalog”).
Section II. 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 via cell phone to a parent/guardian in case of emergency.
3. Be advised that Dual Enrollment students are treated like any other college student; therefore a complete Mission College authorization
form and photo ID is required if a parent/guardian wishes to conduct business on their student’s behalf.
NOTE: For safety and liability purposes, all students under 18 years of age will be identified to the Instructor.
Dual Enrollment Program Policies and Procedures
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