Fillable Request for Approval S (Parkland College)

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Request for Approval S (Parkland College)

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Country of origin: US
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U.S.A. forms for Parkland College

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2400 W. Bradley Avenue
Champaign, IL 61821
217/351-2218
www.parkland.edu
S
TUDENT INFORMATION Date of Request: _________________
Name: _______________________________________________ Parkland ID: ______________
Address: ____________________________________________________________________________
Street Apt. City Zip Code
Cell phone: _________________________________ Email: __________________________________
Home community college/district number: _________________________________________________
S
TUDENT PETITION
I wish to enroll at Parkland College and receive the tuition benefits under the Career Agreement based on the fact
that my home community college does not offer the career program of my choice. This agreement shall be
reviewed annually by the college and will be in effect as long as I am pursuing the career program listed below.
Career Program at Parkland College: _____________________________________________________
Program Application Status:
I have been accepted into the program I have not yet been accepted into the program
Beginning Semester:
Fall Spring Summer 20 _______ Anticipated completion of the program: ___________
Authorization-to-Enroll Letter:
I requested an Authorization-to-Enroll letter from my home community college on _____________.
Date
Form Submission Send the completed form to:
Career and Technical Education Division
Parkland College, Room M120
2400 West Bradley Avenue
Champaign, IL 61821-1899
Email: cte@parkland.edu
TO BE COMPLETED BY ADMINISTRATION
Authorization-to-Enroll Letter received on ________________________________ (date)
Petition for Career Agreement tuition benefits: APPROVED
Petition for Career Agreement tuition benefits: DENIED
________________________________________________________________________________
Dean: Name & Signature Division Date
Career Agreement
Request for Approval
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Request for Approval S (Parkland College)

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Completed 15 September 2020

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