Fillable Postsecondary Enrollment Options (PSEO) Program Application HS JUNIOR (Saint Cloud State University)

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Postsecondary Enrollment Options (PSEO) Program Application HS JUNIOR (Saint Cloud State University)

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St. Cloud State University does not discriminate on the basis of race, sex, color, creed, religion, age, national origin, disability, marital status, status with regards to
public assistance, sexual orientation, gender identity, gender expression, or status as a U.S. veteran. For additional information, contact the Office for Institutional
Equity & Access, (320) 308-5123, Admin. Services Bldg. Rm 121.
A member of Minnesota State
Postsecondary Enrollment Options
(PSEO) Program Application
HS JUNIOR & SENIORS
Postsecondary Enrollment Options (PSEO) at St. Cloud State University is a program that allows eligible, 10
th
, 11
th
,
and 12
th
grade students to earn college credit while still in high school, through enrollment in and successful
completion of nonsectarian, college-level courses on a college campus or online. Students may take PSEO courses on
a full or part-time basis. The PSEO program provides students with a greater variety of class offerings as well as the
opportunity to pursue more challenging coursework than may be available at the high school. The tuition, fees and
required textbooks are at no cost to students.
Please note that non-Minnesota resident students to include students in cultural foreign exchange programs (J-1 visa)
and students from another country attending a Minnesota school under an F1 student visa or B visitor visa are not
eligible for PSEO participation. Please contact pseo@stcloudstate.edu for questions about eligibility.
TO BE COMPLETED BY APPLICANT
Full Legal Name _________________________________________________________________
Last, First Middle
Date of Birth ____ / ____ / __________ Gender ☐ Male ☐ Female ☐ Other
Personal Phone Number ( _____ ) ______ - __________ Student Email Address ____________________________
Home Address _____________________________________________________________________________________
Street Address City State Zip
Name of parent/guardian ______________________________________
Anticipated high When do you plan to
school graduation date __________________ begin taking courses? : ☐ Fall ☐ Spring Year ___________
(Month, Year)
Name of secondary/home school you are attending ______________________________________________________
Social Security Number ____ ____ ____ - ____ ____ - ____ ____ ____ ____
Federal law allows the colleges and universities of Minnesota State to request and use your social security number. While you are not legally required
to provide your social security number on this form, you are strongly encouraged to do so. Your social security number will be used for routine record
keeping, institutional statistics, research and required state and federal reporting.
Please read the following statements and acknowledge by checking each box:
☐This is my application to St. Cloud State University under the Postsecondary Enrollment (PSEO) Act. The information
provided on this form is true and correct.
☐ I understand that my application will not be reviewed until all forms are submitted to include a completed Notice of
Student Registration form and official high school transcript.
Signature ______________________________________ Date ___________________________
TO BE COMPLETED BY HIGH SCHOOL OFFICIAL FOR APPLICANT
☐ This student is in good academic standing and is eligible to participate in PSEO programming through class
rank, high school GPA, or nationally standardized test score. Documents supporting eligibility (transcript or test
score report) are attached to this application.
Signature of certifying official _______________________________ Title ___________________________________
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St. Cloud State University does not discriminate on the basis of race, sex, color, creed, religion, age, national origin, disability, marital status, status with regards to
public assistance, sexual orientation, gender identity, gender expression, or status as a U.S. veteran. For additional information, contact the Office for Institutional
Equity & Access, (320) 308-5123, Admin. Services Bldg. Rm 121.
A member of Minnesota State
PSEO NEW STUDENT AGREEMENT FORM
As a St Cloud State University Post-Secondary Enrollment Options (PSEO) student I understand that I must adhere to the
following policies and expectations to remain eligible for the program, including the SCSU Student Code of Conduct and the
SCSU PSEO program policies:
I understand that I am responsible for reading, understanding, and following all the guidelines and procedures listed in the PSEO
student handbook and my signed student agreement form. I understand updates to program policies and procedures will be
provided on the PSEO student D2L and to me via my SCSU email.
I understand that I am responsible for my own attendance in my courses and my personal academic progress and success. I will take
initiative to ask questions and seek assistance from the PSEO staff, my faculty members and student support services.
I understand that I must submit my Notice of Student Registration Form (3-part NOSR form) each semester prior to registration.
I understand that if I do not submit the form that I may be responsible for the charges or that my classes may be dropped. I will
maintain a copy of my NOSR form to avoid any issues with submission or billing.
I understand that I am responsible for scheduling an appointment with a PSEO team member each semester to discuss upcoming
course registration if I have questions.
I understand that I must maintain a minimum cumulative SCSU GPA of 2.0 and a credit completion rate of 66.67% to continue
my participation in the program. Failure to do so will result in my immediate and permanent suspension from the PSEO program at
St. Cloud State University. I understand that I must make my own arrangements to return to my high school for subsequent terms.
I understand that I may register for I00 and 200 level courses, which are typically introductory courses and courses for which I meet
the minimum posted requirements/pre-requisites. I understand that 300 and 400 level courses are upper division courses and are
typically major-based courses, and that a discussion with the faculty member before enrolling is appropriate and expected.
I understand any course numbered below “100” is not covered by PSEO as they are considered developmental coursework and not
college-level work.
I understand the official form of communication for SCSU and the PSEO program is my SCSU email. I agree to check my SCSU
email account regularly to ensure receipt of important announcements. I am responsible for information included in the messages.
I understand that all books and materials charged to and/or reimbursed by SCSU are property of the University. I agree to return
all books/materials charged to and/or reimbursed by SCSU to the Husky Bookstore (in Centennial Hall) during finals week. I
understand a hold will be placed on my account and that I must pay replacement costs for all items not returned on time.
I understand that if I wish to continue my education at SCSU after high school graduation, I must apply using the Undergraduate
Application for Admission, submit an official high school transcript following the deadlines for admission, scholarships and
financial aid.
I understand that I must submit a completed application for degree admission by March 1st in order to receive all benefits available
to PSEO students who continue their education at SCSU. Students in good standing, having earned 15+ SCSU credits through on-
campus courses by the end of spring term of their senior year may be eligible for early registration opportunities. I understand that
if I plan to continue at SCSU, I am required to participate in an Advising & Registration Program.
I understand that as a PSEO student I must meet the same conduct and academic expectations of a degree-seeking University
student; status as a PSEO student is not an excuse for poor academic performance or conduct issues.
I understand St. Cloud State University will notify my high school of my semester enrollment and academic performance as long as
I do not have a financial hold on my account. I understand that my course registration and term grades will be submitted once per
term to my high school by SCSU.
Student name Student signature
Parent/Guardian Signature (required if student is under the age of 18)
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St. Cloud State University does not discriminate on the basis of race, sex, color, creed, religion, age, national origin, disability, marital status, status with regards to
public assistance, sexual orientation, gender identity, gender expression, or status as a U.S. veteran. For additional information, contact the Office for Institutional
Equity & Access, (320) 308-5123, Admin. Services Bldg. Rm 121.
A member of Minnesota State
DEMOGRAPHIC INFORMATION
T
he following information will help St. Cloud State University evaluate student recruitment and retention policies; it will not be
used as a basis for admissions. Providing this information is voluntary.
Are you Hispanic of Latino (a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other
Spanish culture, regardless of race) ☐ Yes ☐ No
Race and ethnic background (select any that apply)
☐ American Indian or Alaska Native (a person having origins in any of the original peoples of North, Central or South
America and who maintains tribal affiliation
☐ Asian (a person having origins in any of the original peoples of the Far East, South Asia or the Indian subcontinent)
☐ Black or African American (a person having origins in any of the black racial groups of Africa)
☐ Native Hawaiian/other Pacific Islander (a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or
other Pacific Islands
☐ White
ACCESS TO ADMISSION APPLICATION FILE
St. Cloud State University complies with federal and state privacy laws and regulations. Those who may gain access to
information in your file are staff and faculty at St. Cloud State University who have a need to gain access, your high school
administration, and outside organizations and government bodies in limited circumstances as authorized by state or federal law.
In addition, you may view your own file. No one else may view your file without your written consent or a subpoena or court
order. If you want the University to give information to someone else such as your parent, spouse or other relative or friend
you must complete and sign this section of the application. This consent will remain in effect for one year from the date you
sign unless you advise the University earlier that you want to withdraw your consent. If you give someone else access to your
application, that person may be able to help us process your application. I authorize the following persons to receive
information in my St. Cloud State University application file:
Name _____________________________________________ Relation to Student ________________________
Student’s Signature __________________________________
PLACEMENT TESTING
Students admitted to the St. Cloud State University PSEO program must submit placement scores (ACT, SAT or Accuplacer)
or complete appropriate placement testing before registration. Scores may affect enrollment in courses.
TRANSFER ANY COMPLETED COLLEGE CREDIT
This step could be important to help you place into appropriate courses. This can be done by requesting official transcripts
from those universities to be sent directly to SCSU. AP Scores may also be accepted from an official report through The
College Board. If you have completed coursework through another Minnesota State College & Universities institution, you do
not have to pay for an official transcript. Please request a free transfer by emailing pseo@stcloudstate.edu with the institutions
you attended.
This completed application, the student’s completed Notice of Student Registration form and an official copy of the student’s
high school transcript must be sent to the PSEO Office for admission. Transcripts submitted by parents and students are not
considered official unless sealed. This form is not an application to become a degree seeking student with St. Cloud State
University. All application materials must be received or postmarked by the following dates. Early applications are highly
encouraged to provide maximum opportunity for planning.
Fall Semester – June 1 Spring Semester – November 1
Please return application materials to: Questions?
St. Cloud State University Email: pseo@stcloudstate.edu
Postsecondary Enrollment Options Web: www.stcloudstate.edu/pseo
103 Administrative Services Building Phone: 320-308-5758
720 4
th
Ave. S.
St. Cloud, MN 56301
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Postsecondary Enrollment Options (PSEO) Program Application HS JUNIOR (Saint Cloud State University)

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Completed 16 February 2022

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