CUESTA COLLEGE
Admissions & Records
Phone: (805) 546-3955
Fax:
(805) 546-3975
*Authorized signatory designees have been submitted by school’s Principal to Cuesta College.
GRADES 9-12
This Permit to Enroll is to be completed by the student and authorized by their principal and parent/guardian to concurrently
enroll at Cuesta College. Please refer to the back side for Enrichment Program policy and registration directions. Allow five
(5) days processing for data entry of approved courses from Permit to Enroll, which can be confirmed in myCuesta under
“Registration Status.” Before submitting this form, the student must complete the following steps:
1) Apply online at http://www.cuesta.edu/admissionsaid/apply (Required every term Enrichment student plans to attend.)
2) *Confirm age limit prerequisite has been met for course(s) as of the start of term.
Attach Petition for Enrollment in Age-Restricted Courses if approved.
(It is the student’s responsibility to obtain instructor approval on age-restricted course petition.)
3) Home schooled students must attach a copy of a current Private School Affidavit.
4) Complete Enrichment Student Orientation and attach Certificate of Completion: http://bit.ly/cuestaenrichment
Returning Enrichment Students are not required to retake or submit Enrichment Student Orientation
This permit does not register a student nor guarantees a seat will be available in courses requested at the time of
registration.
9 __ __ __ __ __ __ __ __
Last Name First Name
M.I.
Cuesta Student ID Number
Circle Grade Level: 9
th
10
th
11
th
12
th
______/_____/______ (______)_____—___________
Birthdate Student Contact Phone Number
High School Counselor Name:__________________________________________________________
( ) —
School Name (Please list city/state if outside San Luis Obispo County) School Phone Number
Type of School: Public High School Private School Home School (Please attach affidavit)
Private Tutor (Please attach teaching credential) Other:
Select Term: Fall Spring Summer Select Year: 20______
List both desired and alternate courses in case a class is closed, cancelled, or a prerequisite is not met.
Specify subject and course number. Kinesiology (Physical Education) activity courses are not allowed.
*Subject
Number
Course Title Credits
**For English/Math Courses Only (AB705)
Signature Required: As an authorized designee or principal, I have
reviewed the student’s academic history and recommend the student
for the listed English or Math course.
Ex: MATH 127 Intermediate Algebra 5.0
**Signature if English/Math:
**Signature if English/Math:
**Signature if English/Math:
**Signature if English/Math:
**Signature if English/Math:
Maximum of 11.999 credits per semester and
maximum 9.0 credits for summer session.
*Verify Course Age Restrictions:
http://www.cuesta.edu/student/documents/admissions_records/agelimit.pdf
Parent, Student, Principal – please read the following information carefully and approve below:
By entering a college environment, students who are minors will be exposed to a diverse population in educational programs designed for the adult
learner that may involve sensitive topics that might be considered controversial or offensive in the secondary school setting. Students also have
open access to the Internet on campus computers and access to family planning (pregnancy testing, HIV testing, condoms) in the Health Center.
All college coursework is governed by the Family Education Rights and Privacy Act which allows release of academic information, including grades,
to the student only – regardless of age. Academic information is not released to parents or third parties, in-person or by phone, unless consent is
authorized by the student via FERPA Release Form available in myCuesta Student Quick Links under Forms.
If a class does not meet at its scheduled time (i.e. cancelled class or ends early), Cuesta College does not inform parents or guardians nor will staff
or the instructor assume responsibility for students once a class is released.
I have read the above and authorize par
t-time enrollment at Cuesta College:
Student’s Signature Date
*Authorized Designee or Principal’s Signature Date
Parent or Legal Guardian’s Signature Date
OFFICE USE ONLY Date received: ___________________
Check the following:
______ Applied (SAAADMS) ______ No KINA Classes
______ Check Term ______ Approval Signatures
______ SOAHSCH update High School
______ SOATEST
(math/Engl) ______ SVAMSTD (math/Engl)
Registration Aide Initials: ____________________________
Date entered (SFASRPO): ___________________________
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