Office of Student Accounts
Dual Enrollment Authorization
It is understood that Henry Ford College will transmit a bill to the student’s school district
detailing the tuition and fees of the above named student. If the student is enrolled in a
nonpublic high school, the bill will be sent to the State of Michigan.
I acknowledge that this school district is responsible for the lesser amount of: 1) The actual
charge of tuition and fees or 2) the students foundation allowance, adjusted for the proportion
of the school year the student attends our school district. The student is responsible for the
remainder of the tuition and fees, if any. The student is eligible to enroll in the following
course(s) at Henry Ford College as a dually enrolled student.
I certify that the above named student meets all the conditions outlined in the Postsecondary
Enrollment Options Act 160 of 1996, and is currently eligible for dual enrollment at Henry Ford
It is understood that forms must be submitted to Henry Ford College prior to posted
Payment Due Dates to insure classes are not de-registered.
High School Counselor Authorization
The student has received the counseling suggested by the Public Acts 160 and the necessary
information about the postsecondary options.
High School Counselor Print and Sign Date