1. If you have never applied or enrolled at JSRCC, complete the Web Application for Admission. Once you receive confirmation that the
application has processed, print the confirmation page and print the application.
2. To attend J. Sargeant Reynolds Community College while currently enrolled in a home-schooled program you must be a high school
junior or senior. High School freshmen and sophomores interested in taking classes at JSRCC must request special approval from the
College President
3. Obtain a copy of the approved “Letter of Intent to Instruct” from your respective county/city school system.
4. If testing is a prerequisite for the requested course(s), make an appointment for placement testing. Please refer to the college Catalog
for course requirements.
5. If you are requesting test waivers, obtain Official SAT/ACT score reports.
6. Have this form completed and signed by the parent who is serving as your “principal” each semester.
7. Please bring all forms and documents to the campus Success Center during published on-campus registration dates.
8. If you need additional information, please call 523-5030 to speak with a college representative.
Student’s SSN: EmplID: (On Confirmation sheet)
Last Name First Name Full Middle Jr.,3rd
SIGNATURE OF STUDENT: DATE:
SIGNATURE OF PARENT DATE SIGNATURE OF PRINCIPAL (if different from parent)
This student wishes to take the listed classes designated above.
Parent requests waiver of the COMPASS Placement Test for Reading and Writing based on test scores: (Official score reports required)
SAT Verbal: Date:
PSAT Verbal: Date:
ACT English: Reading: Date:
Writing and reading minimum required: SAT - 500; PSAT - 52 ACT minimum required: English-19+ Reading-20
Parent requests waiver of the COMPASS Placement Test for Mathematics based on test scores: (Official score reports required)
SAT Math: Date:
PSAT Math: Date:
Math Minimum required: SAT - 500; PSAT - 52
JSRCC Form No. 11-0030 Home Schooled Student-Enrollment form 02/08
This institution promotes and maintains educational opportunities without regard to race, color, sex, ethnicity, religion, gender, age (except when age is a bona fide occupational
qualification) handicap, national origin or other non-merit factors. Employer, date of birth, social security, sex and race information are optional and used for research, reporting and
management of student records.
Desired semester/term
FALL TERM (Aug - Dec) 20 SPRING TERM (Jan - May) 20 SUMMER TERM (May - July) 20
PARENT/PRINCIPAL COMPLETES THIS SECTION
Requested Classes at JSRCC
CLASSES For HS Credit
(check Yes/No)
Course
Subject
Course
Number
5-digit
Class ID#
Course
Section
Title YES NO
ITE 100 74319 01PR INTRO TO INFORMATION SYSTEMS
E X A M P L E
J. SARGEANT REYNOLDS COMMUNITY COLLEGE
HOME SCHOOLED STUDENT ENROLLMENT
click to sign
signature
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click to sign
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signature
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