Dual/Concurrent Credit
High School Registration Permission Form
Term: Fall Spring Summer Year: 20 ____ New Dual Credit Student Returning Dual Credit Student
Name of Student: CWID# DOB: _____/_____/_____
Current School: Current Grade Level: HS Graduation Date (MM/YYYY): ______/_______
I understand that if I am admitted under this program, I will abide by the rules and regulations of Collin College, including official
registration and withdrawal procedures. I also understand that academic information such as test scores and college transcripts
will be provided by Collin College upon request to my corresponding high school.
I understand that I will be registering in a college credit course(s) and will receive a performance (letter) grade which will be
recorded on my permanent record at Collin College. Tuition must be paid by posted payment deadline. Courses follow the
Collin College calendar as outlined in the student Registration Guide. I acknowledge that turning in this form only grants
me permission to take courses and that I must register online through my CougarWeb account.
Continued participation in this program requires: 1] satisfactory academic performance as it relates to Collin Colleges Academic
Standards defined in the College Catalog 2] parental (if under 18) and school approval for each subsequent semester of
enrollment.
Official high school transcripts are not required to participate in the Collin College Dual Credit Program. However, one may be
required to demonstrate college readiness and to confirm academic information such as test scores, grade classification,
vaccination, and other pertinent information.
I certify that I intend to enroll for the above term in a dual credit course that will be taught online or at a public or private K-12
facility, not located on a Collin College campus. I understand that if I enroll in course(s) that will be taught at a Collin College
campus that I will be required to provide proof of a valid vaccination at least 10 days prior to the first day of the first semester or
the course(s) will be dropped from my schedule.
________________________________
Student Signature Date
I agree to these provisions of admission and enrollments hereby listed for consideration of the students acceptance and understand
he/she must abide by the rules and regulations of Collin College. I understand the student will be responsible for any charges
remaining on his/her account not covered by any applicable waivers and is subject to Collin Colleges Student Financial
Responsibility Agreement.
I understand the student may be exposed to adult material in the classroom and open laboratories, including libraries, learning
centers and computer labs. I understand that once the student is registered in a college course he/she is under the rules of the
Family Educational Rights and Privacy Act (FERPA), and I may not have access to my students records without his/her written
permission on the FERPA release form.
My signature below acknowledges that I have read and understand the policies above.
Parent / Legal Guardian Signature Date
To be Completed by Parent or Legal Guardian
20
Other
Course Name and Number
(ENGL 1301, GOVT 2305, etc.)
CRN
Dual
Credit
Concurrent
Credit
High School Counselor or Official Signature Date
To be Completed by High School Counselor or Official
Eligible for TSI waiver based upon:
/ EBRW: _______________ __________________
(460 or higher) Test date (mm/dd/yyyy)
PSAT/NMSQT:
/ Math: _______________ ___________________
(510 or higher) Test date (mm/dd/yyyy)
/ _English II: _______________ __________________
(4000 or higher) Test date (mm/dd/yyyy)
STAAR:
/ _Algebra I: _______________ ___________________
(4000 or higher) Test date (mm/dd/yyyy)
Final Numeric Grade in Algebra 2 course: ________
(Grade of 70% or higher)
/ English: _______________ ___________________
(435 or higher) Test date (mm/dd/yyyy)
ACT Aspire:
/ Math: _______________ ___________________
(431 or higher) Test date (mm/dd/yyyy)
Not eligible for TSI waiver
My signature certifies that the above information on this form is true and correct.
Revised 03/2020
Date Received: ____________ Collin Staff Initials: _________
The above name student is eligible for the National School Lunch Program (NSLP), also known as free/reduced lunch program,
for the specified term as listed on this form.
Yes, eligible No, not eligible
Name of Student: CWID# DOB: _____/_____/_____