Fillable PIERCE COLLEGE P~a HIGH SCHOOL RELEASE (Pierce College at Puyallup)

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PIERCE COLLEGE P~a HIGH SCHOOL RELEASE (Pierce College at Puyallup)

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HIGH SCHOOL
RELEASE
PIERCE
COLLEGE
Pierce College Fort Steilacoom, 9401 Farwest Dr. S.W., Lakewood, WA 98498-1999 Pierce College Puyallup, 1601 39th Ave. S.E., Puyallup, WA 98374-2222
Name: ________________________________________________________ SID #: ___________/_________/______
Address: ______________________________________________________ Birth Date: _________________________
City/State/Zip: __________________________________________________ E-mail Address: ____________________
Phone: (________)__________________
High School: ___________________________________________________ Date last attended: __________________
Address: ______________________________________________________ Phone: (________)_________________
City/State/Zip: ________________________________________________________________________________________
This release is valid for: Year 20___ Summer Fall Winter Spring
Please check the appropriate option:
1. Courses to be taken through Pierce College for High School credit. The high school counselor or home
school parent is responsible for listing acceptable courses below. The student will be blocked from
registering if the Pierce Course section is not completed.
_____
2. Individual may take courses, but not for high school credit. _____
3. Individual to work toward a high school diploma from Pierce College. An o˜cial transcript must be
provided with this release.
_____
4. GED preparation and/or Adult Basic Education (ABE) classes.
(A separate release form is required for GED testing.)
_____
5. Testing _____
Pierce College Courses or Test Name
P~a
•
D D D D
-----□
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Printed name
High School Position
Authorized Signature
Home School Parent
Student Signature
Pierce College Contact Information
Department Fort Steilacoom Puyallup Military Sites
Admissions (253) 964-6501 (253) 864-3254 Fort Lewis - (253) 964-6567
McChord AFB - (253) 964-6606
Adult Basic Education (253) 964-6714 (253) 840-8463 NA
GED Classes (253) 964-6657 (253) 840-8463 NA
GED Testing (253) 964-6439 (253) 840-8343 McChord AFB - (253) 964-6606
High School Completion (253) 964-7324 (253) 840-8461 NA
09-25-13 KM
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PIERCE COLLEGE Pa HIGH SCHOOL RELEASE (Pierce College at Puyallup)

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Completed 9 October 2020

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