Fillable K-12 Special Admission Unit Peon Form (Palomar College)

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K-12 Special Admission Unit Peon Form (Palomar College)

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Palomar College | Oce of Admissions | Admissions@palomar.edu | (760) 744-1150 ext 2164
K-12 Special Admission Unit Peon Form
Palomar Student ID Number
Semester/Year: Summer _______ Fall _______ Spring _______
A. Student's Name - Last, First, MI B. Date of Birth
C. E-Mail C. Telephone D. Total Semester Units Requesng
Oce of Admissions | Admissions@palomar.edu | (760) 744-1150 Ext 2164
Version 11/2021
K-12 SPECIAL ADMISSION UNIT PETITION FORM
STUDENT: In addion to the Unit Peon form you must also submit:
Unocial transcripts from all schools and wrien AND wrien juscaon in the box below:
Course(s) Requesng:
_____________________________________________________________________________________________________________
Wrien Juscaon: (Explain below)
PARENT or GUARDIAN: Sign this form to request your student to exceed the 7 unit limit for Fall or Spring and 5 Unit limit for Summer.
PRINT Name of Parent/Guardian: Date:
Signature of Parent/Guardian:
I cerfy under penalty of perjury that the statements in this form are true and complete to the best of my knowledge. I understand that falsicaon may result in my student’s dismissal.
******************FOR OFFICE USE ONLY******************
Approved by Director of Enrollment Services: Date: Units Approved:
K-12 SPECIAL ADMISSION UNIT PETITION FORM – FULL TIME
(Complete this secon ONLY if peoning 12 units or more)
COUNSELOR/PRINCIPAL/DISTRICT OFFICIAL: Complete the K-12 Special Admission Unit Peon form to allow student to aend Palomar College as a
full-me student (12 units or more).
• K-12 Students are limited to 7 units per semester in fall or spring term and to 5 units in summer session. Students requesng enrollment in
excess of these limits must complete the K-12 Special Admission Unit Peon form and obtain approval of the Director of Enrollment Services.
Students requesng 12 units or more must also obtain permission of their high school on the K-12 Special Admission Unit Peon form.
K-12 STUDENT ACKNOWLEGEMENT (Inials Required)
I acknowledge that if approved to enroll in 12 units or more I am fully responsible for ALL enrollment fees for ALL units registered as well as
all the mandated fees associated with enrollment.
Important: Non-resident/Foreign Tuion Fee $307 per unit* in addion to enrollment and mandated fees.
PLEASE PRINT (Permission from High School is Required)
Name of Counselor/Principal/District Ocial: School Name:
Signature of Counselor/Principal/District Ocial: City:
Date:
*High school students who are considered nonresidents of the State of California for educaonal purposes and who are registered for college credit will be
subject to nonresident tuion fees.
Educaon Code Secon 68090, Title 3, Part 41,
Educaon Code Secon 48800.5
******************FOR OFFICE USE ONLY******************
Approved by Director of Enrollment Services: ______ Approved: Denied:
(Year) (Year) (Year)
INITALS
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K-12 Special Admission Unit Peon Form (Palomar College)

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Completed 12 April 2022

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