Fillable STUDENT INFORMATION SECTION (Ferris State University)

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STUDENT INFORMATION SECTION (Ferris State University)

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  • 4 check-boxes
  • 43 other fields

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Dual Enrollment Course Registration & Payment Information Form
STUDENT INFORMATION SECTION
Student’s Name (Legal):
Last
First
Middle
Semester I plan to take courses: □ Fall 2020 □ Spring 2021 □ Summer 2021
Course Selection(s)
Course Title
Course
Prefix
Course
Number
Section
Number CRN Campus
Week
Meeting
Times
# of
Credits
Check here if no high school credit is to be awarded.
I have read and understand the guidelines of dual enrollment. I give permission to my high school to release my
transcript and any grades or test scores to Ferris State University.
Student signature
Date
2020-21 TUITION INFORMATION
The Ferris State University Board of Trustees will approve the 2020-21 dual enrollment tuition rate in Summer 2020.
Schools may wish to use the 2019-2020 dual enrollment tuition rate of $274 per credit hour as a general guideline when
projecting tuition costs for the 2019-2020 academic year. The $274 per credit hour rate is not guaranteed and tuition rates
are subject to change. There is an additional fee for online classes. For the 2019-2020 academic year, the fee was $12 per
credit hour.
HIGH SCHOOL INFORMATION SECTION
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 Ferris State University. It is understood that the Ferris State
University will send a bill to the School District listed on page 2 detailing the tuition and fees of the above-named
student. I acknowledge that our district is responsible for the lesser amount of: 1) The actual charge of tuition and fees
or 2) the student’s foundation allowance, adjusted to 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 above course(s) at Ferris State University as a dual enrolled student.
FINANCIAL CALCULATION (FOR HIGH SCHOOL USE ONLY)
Check one:
Amount covered to be determined*
*finalized amounts can be confirmed by submitting a new form or emailing dualenrollment@ferris.edu
All tuition and fees covered (including the $12/credit hour fee for online classes)
School will pay a certain amount per course or will authorize a maximum amount
$_
_____________ per course OR $____________ maximum amount authorized for all courses
I
approve this student to apply for Dual Enrollment. By signing this form, I agree that the high school/tech center will
pay Ferris State University the “School District Costs” listed in the Financial Calculation section of this form.
High School
Counselor/Principal name
(please print)
High School Counselor/Principal
signature
Date
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signature
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signature
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Dual Enrollment Course Registration & Payment Information Form
PARENT/LEGAL GUARDIAN SECTION
I have reviewed the financial information on page 1 and agree to pay the amount not covered by the school.
I understand that I am responsible for payment of any charges incurred by the student that are NOT covered by the
school district while the student is dual enrolled. I have read and understand the guidelines for dual enrollment. I give
permission for my student to participate in the Dual Enrollment Program at Ferris State University. I understand
that course content, instruction, academic expectations, and supporting materials have been developed for adult
students typically age 18 or older. The grades a student receives in dual enrollment ultimately become a part of the
student's permanent college and high school transcript.
Parent or Legal Guardian signature
Date
DUAL ENROLLMENT ADMISSIONS AND REGISTRATION
The student must complete the free online application at www.ferris.edu/dualenrollment.
The high school should send the student’s high school transcript, test scores, and this form to dualenrollment@ferris.edu.
The financial calculation on page 1 of this form should be completed.
All students will be registered by the FerrisNow Program.
INVOICE INFORMATION (HIGH SCHOOL USE ONLY)
School:
Attention:
Address:
City:
State:
Zip:
Telephone:
Fax Number:
PAYMENT INFORMATION FOR HIGH SCHOOLS, CAREER TECH CENTERS, AND ISDS
Payment is due 30 days after receiving invoice from Ferris State University.
High school/tech center/ISD will be invoiced for all students who complete the application and enroll in a
University course(s).
FOR MORE INFORMATION
FerrisNow Program
Office of Transfer and Secondary School Partnerships
Ferris State University
901 S State Street, STR 313
Big Rapids, MI 49307
Phone: (231) 591-5983
Email: dualenrollment@ferris.edu
Web: www.ferris.edu/dualenrollment
Ferris State University is an equal opportunity institution. For information on the University’s Policy on Non-
Discrimination, visit ferris.edu/non-discrimination.
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STUDENT INFORMATION SECTION (Ferris State University)

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Completed 20 August 2020

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