International Student Services
Concurrent Enrollment Request Form
century.edu | 651.779.3300
3300 Century Avenue North, White Bear Lake, MN
55110
1
Important information regarding concurrent enrollment (also known as off-campus enrollment) for F-1 students:
Students may only take off-campus courses at colleges and universities that are SEVP-certified.
This form must be completed every semester that a student requests to take courses at another college or university
(i.e. off-campus).
F-1 students must enroll for a minimum of 12 credits each semester. A minimum of 8 credits must be registered at
Century College each semester. (The 8 credit minimum may be waived for students declared in programs with required
consortium credits.)
This form must be completed before the student will be registered in SEVIS for the semester. Without SEVIS registration
a student will be out-of-status.
In order to transfer credits to Century College, after completing the off-campus course students must submit an official
transcript to Transfer Student Services, W2240.
Instructions for Requesting Permission for Concurrent Enrollment:
1. Register for the off-campus course and complete tuition payment.
2. Fill out the form below and submit to an International Student Advisor in W1221 at least 10 business days before
semester start. Include the following documents:
a. Receipt indicating payment for the course
b. Proof of enrollment, Example: copy of registration or unofficial transcript
3. After completion of the course, submit a copy of your transcript to International Student Services to verify completion of
the off-campus course.
Part 1. To Be Completed by the Student: Please Type or Print Clearly
Student Name: ______________________________________________________________________________________________
Student ID: __________________________ Phone:______________________ Email: ____________________________________
Degree Program: ____________________________________ Semester of Enrollment: _________________________________
Name of College/University where course(s) will be taken: ________________________________________________________
Title of Course(s): ___________________________________________________________________________________________
Course Number(s): __________________________________________ Number of Credits: _____________________________
Reason for Concurrent Enrollment: ____________________________________________________________________________
____________________________________________________________________________________________________________
I certify that I understand the information above. Between my registration at Century College and my registration at the second
institution I am registered for at least 12 credits. I understand that if I change my registration in any way at Century College or the
second institution without prior approval from Century College International Student Services, I may lose my F-1 status.
_________________________________________________________________ _______________________
Student Signature Date
Century College is a member of Minnesota State. We are an affirmative action, equal opportunity employer and educator. This document can be
available in alternative formats to individuals with disabilities by calling 651.773.1745 or emailing access.center@century.edu.
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Updated 12/04/19
century.edu | 651.779.3300
3300 Century Avenue North, White Bear Lake, MN
55110
2
Part 2. To Be Completed by the International Student Advisor:
The above named student is approved to take the listed off-campus course(s):
Yes
No
Comments:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_____________________________________________________________________ __________________________
International Student Advisor Signature Date
_____________________________________________________________________ __________________________
International Student Advisor Name (please print) Phone
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signature
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