Fill - Free fillable form must be completed prior to each semester's (Jamestown Community College) PDF form

Pre-College Enrollment Program (PEP)

Applicaon

JCC will accept this form only aer the student and counselor or principal have agreed upon the course(s) of study for the fall or spring

semester. Students are encouraged, but not required, to consult with their high school counselor or principal for summer courses. This

form must be completed prior to each semester's enrollment at JCC and returned to the admissions oce for part-me registraon.

(Refer to JCC’s credit course schedule for course and registraon informaon.)

PERSONAL DATA

J-number (if you have one)__________________ telephone number____________________ date of birth__________

student's name_____________________________________________________________________________________________________________

rst name middle inial last name

address___________________________________________________________________________________________________________________

number & street city state zip code

e-mail address_________________________________________ high school_____________________________ expected date of graduaon_______

REGISTRATION SECTION semester:  fall  spring  summer session I  summer session II year__________

We, the undersigned,

 understand that all JCC students are included in JCC’s Family Educaonal Rights and Privacy Act (FERPA) policy. Pursuant to FERPA, ocial

transcripts, grade reports, and other records of academic performance are available only to the student himself/herself unless he/she les an

authorizaon with the college’s registrar’s oce to release this informaon to others or unless required by law.

 understand that PEP students are enrolled in regular credit-bearing, college-level courses and that course content and classroom policies/procedures

will not be modied to accommodate variaons in age/maturity level. We further understand that PEP students are subject to JCC’s student conduct

code which applies to all students.

 agree that tuion and fees will be paid by due dates and accept liability for any collecon costs as a result of failure to pay including, without

limitaon, collecon agency fees, court costs and aorney fees. Student must understand that if any poron of their account remains unpaid at the

end of the semester, their account will be forwarded to a collecon agency within 30-90 days. We further understand that JCC may contact us by

phone, e-mail, or text message regarding any outstanding account using any phone number, cell phone number or e-mail that was provided to the college.

I certify that ________________________________(student’s name)

has been recommended for study at Jamestown Community College.

________________________________________________________

signature - counselor or principal (required for fall and spring courses);

not required for homeschooled students. By typing your name in this signature

box, you are confirming that you are approving this document.

________________________________________________________

signature - parent or guardian (required for all courses)

SEND FORM TO: MAIL: Admissions Oce, Jamestown Community College, Jamestown Campus, P.O. Box 20, Jamestown, NY 14702-0020

FAX: 716.338.1450 | E-MAIL: admissions@mail.sunyjcc.edu

CRN SBJ CRSE NO. CR HRS COURSE TITLE INSTRUCTOR

BEGIN

TIME

DAYS BLDG RM CAMPUS

Student meets prerequisites for PEP based on the following informaon:

Placement test scores:

 Essay_________ Reading_________ Math___________

 High school transcript or homeschooled documentaon aached

 College transcript aached if applicable

Admissions signature:_____________________________Date:___________

FOR OFFICE USE ONLY

ADM received: ______________ Copies to:  registrar’s oce  nancial aid  business oce  online director

Tuion $_____________ PEP Grant $____________ E_________ N/E_________ reason_____________________________

By typing your name in this signature box, you are confirming that you are approving this document.

Admissions requirements to enroll in a PEP course must be met prior to registraon.

Have you done the following?

 Reviewed the prerequisites for classes you wish to register for to ensure you are eligible for the class.

 Placement tested in high school or at JCC.

 Completed the PEP applicaon with all appropriate signatures.

 Aached a copy of your high school transcript or homeschooled documentaon.

 The student must be at least 15 years of age.

Placement Testing:

PEP applicants may be required to take the JCC placement test in reading and/or mathematics to meet eligibility prior to course

registration. For more information and to schedule the test, visit sunyjcc.edu/placementtesting. To determine if testing is required,

please call 800.388.8557, ext. 1065. The test is offered at all JCC locations.

Course Credit:

For course selection, students meet with their high school guidance counselors to determine which classes meet high school

graduation requirements and fit into their daily or weekly schedules. Many PEP students choose to enroll in more than one course

each semester; some have been able to complete a full year of college credit during their last two years of high school.

PEP allows students to complete high school graduation requirements while simultaneously earning college credit. Since some high

schools give dual credit for certain courses, credit earned at JCC may also be applied toward high school graduation requirements.

Credit earned at JCC in courses taken by PEP students may be applied toward an associate degree from JCC or may be transferred to

another institution.

What About Grades and Paying Your Bill?

Enrolled students have secure Internet access to their individual student records at sunyjcc.edu/myjcc. Students can view six-week

and final grades, advisement transcripts, registration, and can access their JCC email account. No paper bills are sent to the student.

Bills can be viewed and paid online in the student’s Banner account.

The student is responsible for requesting that an official transcript be sent to their high school guidance office upon completion of

courses by visiting sunyjcc.edu/transcripts. Unofficial transcripts are available by contacting the registrar’s office in Jamestown,

Student Services Center in Olean, or the main office in Dunkirk.

PEP Grant

The PEP Grant is a financial aid award program for high school students enrolled at JCC through PEP.

 You must be enrolled in a credit-bearing course to receive this award. If you audit a course or register for a non-credit bearing

course, you are not eligible to receive an award for that course.

 You must be aending both high school and JCC classes, or be homeschooled and aending JCC classes.

 You may be enrolled at any of the JCC sites (Jamestown Campus, Caaraugus County Campus, North County Center, or enroll in an

online or distance learning credit bearing class).

 You must be enrolled in at least one, but less than 12, credit hours. The award will be one-half of your tuion charge, up to a

maximum per semester of $500.

 You must be enrolled and in aendance through the fourth week of classes to remain eligible for this award.

 The award will be credited to your account aer the fourth week of classes. If you withdraw prior to the h week of classes, you

will be responsible for tuion and fees in accordance with college policy.

 The deadline for the applicaon is the end of the drop/add period.

 Immediately following high school graduaon you will be eligible for two consecuve semesters as long as you remain a non-

matriculated student and summer part-me study, either preceding or following the two consecuve semesters.

 You must be academically eligible to return to JCC to receive any subsequent disbursements.

 If you are eligible to receive a JCC tuion waiver or are cross-registered with another instuon, you are not eligible for this award.

 Funding for this program is limited. Awards will be made on a rst come, rst served basis.

PEP Grant quesons may be directed to the nancial aid oce:

Jamestown Campus: 716.338.1009 or 1.800.388.8557

PEP Informaon

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