Fillable HCT Homeschool College Transition (Chemeketa Community College)

Fill Online, Printable, Fillable, Blank HCT Homeschool College Transition (Chemeketa Community College) Form

Use Fill to complete blank online CHEMEKETA COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

HCT Homeschool College Transition (Chemeketa Community College)

On average this form takes 19 minutes to complete

The HCT Homeschool College Transition (Chemeketa Community College) form is 3 pages long and contains:

  • 0 signatures
  • 60 check-boxes
  • 46 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Chemeketa Community College

BROWSE CHEMEKETA COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
PROGRAM
REQUIREMENTS
Must be16-18 years old and a
junior or senior in high school.
Must be registered with the
Willamette Education Service
District as a homeschool
student. Students registered
with their resident school or a
public funded program do not
qualify.
Must place into Writing 115,
Reading 90, and Math 95 on the
Placement Test.
PROGRAM
INFORMATION
HCT provides eligible home
school students the opportunity
to get an early start on their
college education tuition free
for up to 5 credits per term.
Student is responsible for the
universal fee ($31 per credit),
course fees, textbooks and a
$50 per term homeschool
student fee.
ENROLLMENT PROCESS
STEP 1: Turn in Application
All students (including 18 year old students) complete the attached Underage
Admission Application, Underage Approval Form (16-17) along with proof of
current registration with the Willamette Education Service District (WESD) -
OR- a current homeschool high school transcript. Please send all forms to
highschool@chemeketa.edu.
STEP 2: Create a MyChemeketa Account
Once your application has been processed you will receive a welcome email
to the email address you provided on your application, please allow 2
business days for processing. This email will include your Chemeketa ID
number and Chemeketa username along with directions on how to create
your MyChemeketa account and instructions on how to take the Placement
Test. Please follow those directions so you are able to access your
MyChemeketa and college email account.
STEP 3: Take Placement Test
In your welcome email, you will also receive step by step instructions on how
to take your college placement test. Please follow the instructions to complete
the placement test. Check your MyChemeketa email account regularly for
placement test results and other communication from the college. Once you
receive your college placement test results, please forward those to your
advisor. Advisor information will be included in the e-mail.
STEP 4: Schedule Appointment with Advisor
After steps 1-3 are completed, you will meet with your advisor to discuss
class options and registration information. You will receive your tuition waiver
at the meeting.
Homeschool College Transition
Chemeketa Community College
HCT
QUESTIONS:
High School Partnerships: highschool@chemeketa.edu - 503-399-5293
Polk Center
: polkcenter@chemeketa.edu - 503-623-5567
First Name
Which term will you enroll at Chemeketa Community College? (choose one)
SSN# (optional)
Middle Name
Last Name
Former Last Name
Mailing Address
State
Zip
Daytime Phone Number
Cell Phone Number
Date of Birth
Email Address
High School Name (no abbreviations please)
City
State
Name of last college attended other than Chemeketa
City
State
Underage Admission Application -
(
Ages 16-17)
Chemeketa High School Partnerships
4071 Winema Place, Bldg. 50, Room 102
Salem, OR 97305
Phone: (503) 399.5293
Email: highschool@chemeketa.edu
You will be issued a Chemeketa student identification (ID) number (K#) to be used as your primary ID. If you provide your social security number to the college it will only
be used for record keeping purposes, complying with federal and state requirements, doing research, reporting, extending crediting or collecting debts. You may be
required to provide your SSN to the college for compliance with specific federal and state regulations such as applying for financial aid, loans, grant programs and tax
reporting requirements. Providing your SSN means that you consent to the use of the number in the manner described. Your SSN will not be given to the general public.
Please note that per OAR 559-004-0400, if you choose not to provide your SSN, you will not be denied any rights as a student.
Summer (June) Fall (Sept.) Winter (Jan.) Spring (March) Year: 20
/ /
Ethnicity and Race: What is your ethnicity? Hispanic or Latino Not Hispanic or Latino Gender: Male Female
Select one or more races to indicate what you consider yourself to be:
American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
Indicate your high school status: (choose one)
Did not complete high school External diploma program Certificate of Initial Mastery Attendance completion GED year
Alternative high school diploma Still in high school Certificate of Advanced Mastery Proficiency exam High school graduation year
Indicate your college status prior to Chemeketa: (choose one)
Have not attended college Short -term training, private vocational school award, or other
Indicate the main reason you are here this term: (choose one)
Take classes to transfer to 4-year college Explore career or educational options Learn English Learn skill to get a job
Take classes to finish high school or GED Improve writing, reading or math skills Improve job skills Personal enrichment Other
Chemeketa Community College releases only very limited information regarding students: enrollment status, dates of enrollment, degree or certificate,
program of study, athletic statistics or honors awarded. If you do NOT want any person outside of the college, including prospective employers, to
know any of these, you must file a request for Non-Disclosure of Student Information form with the Admissions office.
I certify that all statements on this application are complete and true. I also understand that if I am admitted and do not enroll for the term to which I
am admitted, I will need to reapply for admission. Submitted materials will not be returned nor duplicated.
Student Signature: ____________________________________________________________________
Date: ________________________
Email completed form to highschool@chemeketa.edu OR
Drop off at 4071 Winema Place, Bldg. 50, Salem, OR 97305 (please place in mailbox outside of front door)
The College is an equal opportunity/affirmative action employer and educational institution committed to an environment free of discrimination and harassment. Questions regarding sexual
harassment, gender-based discrimination and sexual misconduct policies or wish to file a complaint contact the Title IX coordinator at 503-584-7323. For questions about equal employment
opportunity and/or affirmative action, contact 503.399.2537. To request this publication in an alternative format, please call 503.399.5192.
Will you have lived in Oregon for the
90 days just prior to the term you
begin?
No
Yes
Do you plan to earn a degree, certificate
or diploma at Chemeketa? (choose one)
Yes, high school diploma
No, here to take classes
Undecided
11/9/2020
☐GED Options (HSP)
☐GED preparation classes
☐GED testing only
☐Specialized Programs
☐High School Completion (Winema High
School)
☐College Credit Courses (Underage College
Credit/Early College/Dual Credit)
☐High School College Transition (HCT)
(Mo/Year)
(Mo/Year)
Underage Approval Form - (Ages
16-17)
Chemeketa High School Partnerships
4071 Winema Place, Bldg. 50, Room 102
Salem, OR 97305
Phone: (503) 399.5293
Email: highschool@chemeketa.edu
College Policy 5110 Procedure 5111 requires that this form be completed by students planning to enroll at Chemeketa Community
College who are under the age of 18 and do not have a high school diploma or GED. Completion of this form is not required for
students enrolling in College Credit Now classes that are offered at local high schools.
Student
Last Name: ______________________________________________ First Name: _______________________________________
Date of Birth (month/day/year): ________________________________________ Age: ___________________________________
Please indicate term in which you would like to enroll: ☐Summer (June) ☐Fall (Sept.) ☐Winter (Jan.) ☐Spring (March) Year: 20
Please indicate the program or classes in which you would like to enroll:
Please indicate specific course you wish to enroll: _____________________________________________________________________________
Parent/Legal Guardian
Print Name: ___________________________________________________________ Home Phone: ____________________________________
Signature: ____________________________________________________________ Date: ___________________________________________
High School or Home School Approval
Referring High School/Home School: _______________________________________________________________________________________
Counselor/Administrator Signature: _________________________________________________________________________________________
Telephone: ___________________________________________________________ Date: ___________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - DO NOT WRITE BELOW THIS LINE - - - - - - - - - - - - - - - - - - - - - - - -
☐ Released from Compulsory Education - Beginning Date: _____________________________________________________________________
☐ Exemption from Compulsory Education for GED (student is released for one year) - Beginning Date: __________________________________
☐ Partial Release - Date: _________________ ☐Summer (June) ☐Fall (Sept.) ☐Winter (Jan.) ☐Spring (March)
☐ Partial Release - Date: _________________
Placement Tests: ☐ Completed - Date: _________________
Approved Course(s):
High School Partnerships Signature (credit and non-credit courses): _______________________________________________________________
Community Education Signature (non-credit community education courses only): _____________________________________________________
☐Non-credit classes
☐Expanded Options (EOP)
☐Community Education classes
11-2020
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

HCT Homeschool College Transition (Chemeketa Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document