Fillable IRSC Dual Enrollment Program Agreement

Fill Online, Printable, Fillable, Blank IRSC Dual Enrollment Program Agreement Form

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

IRSC Dual Enrollment Program Agreement

On average this form takes 14 minutes to complete

The IRSC Dual Enrollment Program Agreement form is 2 pages long and contains:

  • 3 signatures
  • 11 check-boxes
  • 38 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Indian River State College

BROWSE INDIAN RIVER STATE 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
 
Dual Enrollment Program Agreement
IRSC Student ID Number
Last Name
(Print legal
name in full)
Suffix
(Jr., Sr., II, etc.)
First Name
Middle
Previous Name
(s)
Mailing Address:
Street Address or PO Box
City
State
Country
Permanent Mailing Address:
Street Address or PO Box
City
State
Country
E-Mail:
Home Phone #
( )
Cell Phone #
( )
Campus preference for Advising and Student Services:
Main/Fort Pierce
Chastain/Stuart
Mueller/Vero Beach
Pruitt/St. Lucie West
Dixon Hendry/Okeechobee
Date of Birth:
2 digit Month/2 digit Day/
4 digit Year
/ /
High School Name/Home School
City:
State:
Graduation Month/Year:
Home School students must also provide a verification letter from their county school
board office confirming their enrollment in an
approved home school program (FS
1002.41).
ELIGIBILITY REQUIREMENTS:
Have a minimum unweighted GPA of 3.0 to enroll in any college credit course or 2.0 for vocational clock
hour courses.
Complete appropriate placement testing and score into college level reading, at a minimum.
Complete Dual Enrollment Program Agreement (Form 508), signed by an appropriate high school
official, the student and parent/guardian.
Complete Dual Enrollment Orientation, submit certificate to your high school counselor and attach a copy
to this agreement.
Meet with your IRSC advisor to develop a Guided Pathway in your first semester of Dual Enrollment.
PLACEMENT TEST SCORES:
Students must achieve the minimum scores noted on either the A.C.T., S.A.T. or P.E.R.T. to enroll in college
mathematics, English, Gordon Rule or other General Education Courses and SLS 1101 per Articulation
Agreement.
College Level minimum scores (pending no future FLDOE changes): Test Type
*Reading:
P.E.R.T. - 106
A.C.T. - 19
S.A.T. - 24
Student’s Scores
Writing/English:
P.E.R.T. - 103
A.C.T. - 17
S.A.T. - 25
Student’s Scores
Math:
P.E.R.T. - 114
A.C.T. - 19
S.A.T. - 24
Student’s Scores
*College level reading scores required for Dual Enrollment.
STUDENT AND PARENT AGREEMENT
We, the student and parent or legal guardian, agree for the above named to enroll in the Dual Enrollment
program offered in coordination with the school district and Indian River State College. We understand the
course selection for enrollment will be authorized each term by the high school counselor for courses that
are creditable toward the high school diploma. We understand that any course that ends after the date of
the student’s high school graduation is not eligible for Dual Enrollment. We agree to abide by the guidelines
of the Dual Enrollment program, as well as the College policies and procedures, while enrolled in IRSC. We
will cooperate with both the high school and the College in fulfilling responsibilities. We understand that any
courses registered for, or grades received, become a permanent part of the student’s college record. At the
end of each semester, we authorize IRSC to forward grades to the high school. Because these credits apply
towards high school graduation, we understand it is the student’s responsibility to receive approval
from the high school counselor for permission to drop or withdraw from a Dual Enrollment course.
We certify that all the information submitted in the agreement is true to the best of our knowledge. We
understand that any misrepresentation of facts may result in the immediate cancellation of the
student agreement or registration.
Student’s Signature:
Student’s Printed Name:
Date:
Parent or Legal Guardian’s Signature:
Parent or Legal Guardian’s Printed Name:
Date:
As a student applying to enter a Dual Enrollment program, I have read, understand, and consent to the
agreement above. I authorize IRSC to discuss my college record with my high school
counselor and the parent or legal guardian listed above.
HIGH SCHOOL AGREEMENT
The
above named student has been given permission to enroll in IRSC as a Dual Enrollment Program
student. I understand this student can only enroll in courses that are creditable toward the high school
diploma. Based on this student’s academic record and over-all maturity, I feel he/she will be successful
in college-level studies, therefore, I recommend this student for the Dual Enrollment program as
indicated above.
Principal or Designee’s Signature:
Principal or Designee’s Print Name:
Date:
HIGH SCHOOL COUNSELOR: IF AVAILABLE, ATTACH A COPY OF THE STUDENT’S ACT, SAT OR
P.E.R.T. TEST SCORES.
IRSC 508 (Rev. 10/2018)
White Copy: IRSC Enrollment & Student Services
Yellow Copy: HS Counselor
Pink Copy: Parent/Student
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
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

IRSC Dual Enrollment Program Agreement

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 10 April 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document