Spring 2017 HIGH SCHOOL STUDENT CHECKLIST
IMPORTANT:
Always identify yourself as a high school student when contacting the Counseling Department.
Check off each item as you read/complete it:
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1. Discuss taking college courses with your high school counselor and determine
specific course(s) to take.
2. Meet minimum eligibility requirements*:
• Complete the 10th grade
• Have at least a 2.5 cumulative high school GPA (9-12 grade)
* Ineligible students should download the flyer “How to Appeal” available on the High School
Partnership Web page at www.chaffey.edu.
3. Submit an application for Chaffey College and receive two email notifications.
Go to www.chaffey.edu and click on “application” on left hand side and follow instructions.
Note: If you have previously applied and have received a Chaffey Student ID number, it is
not necessary to apply again. Returning high school students are not required to re-apply,
but they must submit all required documents found in the student Registration Packet online
prior to registering for classes.
4. Contact the Counseling Department at (909) 652-6200 to sign up for the following
services in the order listed:
a) Assessment Testing
b) High School Counseling Group - HS SEP (must be completed after Assessment Testing)
5. Read and review the contents of the High School Registration Packet and submit the
following high school documents to the Admissions and Records Office.
 Up-to-date official high school transcript in a sealed envelope or via Docufide through
school office
 High School Certification form completed by your high school principal, counselor, or
designee
 Parental Advisory and Liability Waiver
6. After completing Assessment, High School Counseling Group and submitting the
required forms to the Admissions and Records Office, you may register for approved
classes on or after your registration date:
• All high school students must register in person and the maximum allowable course load
for high school students is 8.0 units. High school students may not register for 500 level
courses (i.e. ENGL-575, MATH-510, etc.)
• During the Late Registration Period, all open and closed classes require instructor
consent to add. If the instructor gives you an add code, you must bring it to the
Admissions Office for processing. Fees are due at the time of registration.
• The Admissions Office will verify that course registration matches those classes
previously approved by the high school designee on the High School Certification Form.
• All high school students must meet course pre-requisites and co-requisites as
specified in the Schedule of Classes (go to
http://www.chaffey.edu/counseling/prereqs.shtml for more information about prerequisites/co-requisite requirements.)
7. It is mandatory for high school students to attend the first day of each class for
which they plan to register.
WELCOME TO CHAFFEY COLLEGE!
The California Community College is open to all individuals 18 years or older OR high school graduates,
regardless of age. There is an elementary/middle/high school educational system in place to respond to the
needs of minors pursuing educational goals, and the community college offers opportunities to students
seeking enrichment and/or vocational experience not available at these institutions. Eligibility to
participate in this opportunity is determined by the community college and may not disenfranchise
regular college students.
This is important information every High School Partnership participant should know:
• Registration
• All high school students must register in person at the Admissions Office at the Rancho, Chino or
Fontana Campus. Refer to the CURRENT Schedule of Classes for locations and hours of
operation.
• High school students may not register for 500 level courses (i.e. ENGL-500, MATH-510,
etc.)
• After officially enrolling in classes, a student can make changes to their schedule by adding and/or
dropping. High school students must adhere to all established deadline dates.
• All classes have Last Day to Add, Last Day to Drop and Last Day to Drop with a Refund
deadlines.
• Last Day to Add deadlines can be found at www.chaffey.edu in the Schedule of Classes and Last Day to Drop
deadlines can be found on your Registration Receipt, available onlline via the MyChaffey Portal at my.chaffey.edu.
• Payment of Fees
• Prior to the start of the term, fees must be paid by the date indicated on the current Payment Chart,
which can be found in the Schedule of Classes. If payment is not received, you will be dropped.
• Once the term begins, payment is required at the time of registration. If payment is not received, a
financial hold will be placed on your student record.
• Wait Lists
• High school students who want to wait list for a class that is full, must do so in person
• Wait listing begins once a class is closed
• High school students will need to have a current email on file in order to waitlist
• Please review the Auto-Waitlist function in the Schedule of Classes
• Late Registration
• During the Late Registration Period, all open and closed classes require instructor consent to add. If
the instructor gives you an add code, you must bring it to the Admissions Office for processing.
Fees are due at the time of registration.
• First Date of Attendance
• High school students must be in attendance on the first day of instruction for each class enrolled.
• Pre-Requisite Requirements
• When a course has a pre-requisite requirement, it means that a student must possess a certain
amount of pre-existing knowledge to be successful in the course.
• If the class you are registering for has a pre-requisite requirement, go to the Counseling Department
located in Student Services to complete a Pre-Requisite Validation Request.
• The pre-requisite requirement must be cleared by the Counseling Department prior to registration.
• All students must clear pre-requisite and co-requisite requirements on or before the Last Day to Add
the class in question.
• My ChaffeyVIEW
• High school students are not eligible to register, add or drop online. However, high school students
may use other functions available on the MyChaffey Portal, such as paying fees, printing a registration
receipt, ordering transcripts, etc.
• Deadlines
• There are deadlines for most admission and registration related functions (i.e. adding, dropping,
refunds, petitions, etc.) that are processed in the Admissions Office.
• It is your responsibility to read the calendar located on page one of the Schedule of Classes to
ensure that you meet those deadlines. Deadline dates can also be found on your registration receipt.
If you have any questions related to admissions, registration, fees, ordering transcripts, etc., e-mail
us at admissions@chaffey.edu for assistance.
(Rev.09/01/16)
HIGH SCHOOL CERTIFICATION FORM
STUDENT NAME:
CHAFFEY ID#:
TERM/YR:
FORM MUST BE SUBMITTED ALONG WITH AN OFFICIAL HIGH SCHOOL TRANSCRIPT IN A SEALED ENVELOPE
OR SENT VIA DOCUFIDE THROUGH SCHOOL OFFICE
PART A
RECOMMENDATION AND CERTIFICATION: Part A must be completed by the High School Principal, Counselor, or Designee.
ELIGIBILITY: Student must be completed with 10th grade and have an overall grade point average of 2.50 or better. It is the student’s
responsibility to contact the Admissions and Records Office for assistance, if he/she does not meet the eligibility requirements.
High school students may register for a maximum of 8.0 units per term. Remedial (500 series) classes are not allowed.
* See current Schedule of Classes for specific course information – In person registration is required.
RECOMMENDED COURSES*
UNITS COURSE TITLE & NUMBER
COURSE TITLE & NUMBER
ALTERNATE COURSES*
UNITS
COURSE TITLE & NUMBER
UNITS
COURSE TITLE & NUMBER
UNITS
As Principal or Designee: Pursuant to Education Code 48800, I have reviewed the academic record of the above-named student and certify that the
student demonstrates adequate preparation in the course(s) listed. I certify that I am limiting the number of recommendations to no more than five percent
of the total number of pupils who completed the grade immediately prior to the time of the recommendation for summer session.
X
Signature of Principal or Designee
Date
Print Name of Principal or Designee
High School Name (Please Print)
City and State
(
)
School Telephone Number
PART B
STUDENT ACKNOWLEDGEMENT: Part B is to be completed by the student.
I understand that participation in this special enrollment program provides me with an opportunity to enroll in college courses and to access
programs and services available to all Chaffey College students. I further understand that I am responsible for knowing and following all college
policies and procedures related to academic performance and student behavior as delineated in the Schedule of Classes and the College
Catalog.
I DECLARE UNDER PENALTY OF PERJURY THAT THE STATEMENTS SUBMITTED BY ME ARE TRUE AND CORRECT TO THE BEST
OF MY KNOWLEDGE. All materials submitted by me for purposes of admission become the property of Chaffey College. I understand that
willful omission or falsification of information, or failure to report changes in residence may result in my dismissal from Chaffey College and the
loss of units earned as a result of such omission or falsification.
Student’s Legal Signature
Date
Birth Date
Student’s Address
City/State
Zip Code
NOTICE TO PARENTS
You must sign the Parental Advisory and Waiver of Liability Forms authorizing your son/daughter to be concurrently enrolled at
Chaffey College. The Parental Advisory and Waiver of Liability Forms are included in the high school registration packet and must
be returned with all required documents to the Admissions and Records Office in Rancho, Chino, or Fontana.
(Rev. 09/01/16)
CHAFFEY COLLEGE
PARENTAL ADVISORY FORM
STUDENT NAME:
BIRTH DATE:
CHAFFEY ID#
General Information:
• Course Credit - Courses taken at Chaffey will be recorded on the student’s permanent record at Chaffey College as
college credit.
• Registration - Registration is based on a priority system for continuing college students. Enrollment into desired
courses is not guaranteed.
• Confidentiality of Student Information - Release of student information is not permitted to anyone, including
parents or legal guardians (Ed Code 76243) without written permission from the student. The Release of Information
(Proxy) Form is available in the Admissions and Records Office and on our website at www.chaffey.edu.
• Emergency Contacts - If there is an emergency requiring immediate medical attention, and a parent or legal
guardian cannot be contacted, Chaffey College Student Health Services is authorized to take whatever steps are
needed to protect the health of the student. In the event of accident or sudden illness, Chaffey College will refer to
the emergency contact information below.
EMERGENCY CONTACT INFORMATION (Please Print)
Mother:
Phone: (
)
Father:
Phone: (
)
Alternate Contact/Relationship:
Phone: (
)
Additional Parental and Student Information
• Supervision of Minors - The Chaffey College district assumes no responsibility for the supervision of minor students
outside of the classroom setting. Parents are responsible for providing transportation and ensuring that their children
are appropriately supervised before and after class, and if or when a class is canceled or dismissed at an early time.
Attendance is required, but not monitored, as it is in secondary school systems. Chaffey will not call parent or
guardian if a student is absent, nor will we verify attendance. Students are expected to meet all deadlines for
adding/dropping, refunds, petitioning, etc. It is the student’s responsibility to know college policies and procedures.
Most college deadline dates are posted in the Schedule of Classes.
• Course Content/Material - A college is an adult environment with minimal student supervision. Discussion topics
and course materials are generally designed for adult students and may not be appropriate for younger students.
• Internet Usage - Many courses require computer lab work or research projects that could involve the Internet.
Chaffey’s computer network provides access to the Internet in classrooms, labs, and the library. The College does
not block access to specific Internet sites. As a result, it is possible for your son/daughter to reach an Internet site
that you may feel contains inappropriate material.
Your signature on this document certifies your awareness of the learning environment issues as stated above; that you have
reviewed and assessed your son/daughter’s ability to succeed in the classes recommended by the high school; and that
he/she has your approval to enroll in Chaffey College courses.
Signature of Parent/Legal Guardian
Date:
(Rev. 09/01/16)
WAI VER OF LI ABI LI TY, ASSUM PTI ON OF RISK, AND I NDEM NI TY AGREEM ENT
Participant’s Name:
Chaffey Community College District
Name of Class or Activity: Attendance and Participation in Chaffey College Class(es)
Waiver: In consideration of being permitted to participate in any way in
Chaffey College
Class(es) for Summer, Fall, or Spring
(Description of Activity/Dates)
Hereinafter called the “Activity”, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive,
discharge, and covenant not to sue the Chaffey Community College District, its officers, employees, and agents from liability
from any and all claims including the negligence of the Chaffey Community College District, its officers, employees and
agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to,
participation in the Activity.
Assumption of Risks: Participation in the Activity carries with it certain inherent risks that cannot be eliminated regardless of
the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries
such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks,
and concussions to 3) catastrophic injuries including paralysis and death.
Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD CHAFFEY COMMUNITY COLLEGE DISTRICT
HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s
fees brought as a result of my involvement in the Activity and to reimburse them for any such expenses incurred.
Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is
intended to be as broad and inclusive as is permitted by the law of the State of California including Education Code Section
72640 and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal
force and effect.
Acknowledgment of Understanding: I have read all previous paragraphs, including the waiver of liability, assumption of risk,
and indemnity agreement, know, fully understand its terms, acknowledge these and other risks that are inherent to the Activity,
and understand that I am giving up s ubstantial rights, including my right to sue. I acknowledge my participation is
voluntary, that I knowingly assume all such risks, ant that I am signing the agreement freely and voluntarily, and intend by my
signature to be a complete and unconditional release of all liability to the extent allowed by law.
In the event of any illness or injury, I give full authority to the district staff to obtain such medical treatment and/or surgery from a
licensed physician/surgeon, paramedic or hospital as deemed necessary for the welfare of my child. I acknowledge that I fully
and completely understand the potential risks that may be associated with this Activity and that my child’s participation is strictly
voluntary.
Participant’s Date of Birth (if minor)
Signature of Participant
Date
Parent or Legal Guardian Signature
Date
Please Print Parent or Legal Guardian Name
Name of Health Insurance Company
(
)
Day Phone: Area Code and Number
(
)
Night Phone: Area Code and Number
Policy/Group Number
Medical Problems/ Necessary Medications
Check one: _____None _____Yes, Please Explain:
(Rev. 09/01/16)
PHOTO ID SERVICES
Photo ID cards are required for use of labs, library, and other services. To avoid standing in long lines
once instruction begins, students are encouraged to get their photo ID card as soon as they register
and pay for classes.
Photo ID cards are issued in the Admissions and Records Office at Rancho, Chino and Fontana.
Photo session is single-take only. Services may be limited the week before the first day of instruction
and during the first week of school.
Students may request a photo ID at the Rancho campus during the following hours:
• Monday and Thursday, 8:00 a.m. to 6:45 p.m.
• Tuesday and Wednesday, 8:00 a.m. to 4:15 p.m.
• Friday, 8:00 a.m. to 1:45 p.m.
For services at the Chino or Fontana campus, please refer to the schedule of classes.
HOW TO OBTAIN A PHOTO ID CARD
A student will need to provide one of the following forms of identification when requesting a photo ID
card:
• Government-issued photo ID: Driver’s License, State ID, High School ID, or Military ID
•
Passport
•
Other valid ID (subject to approval)
PHOTO ID RE-PRINTS POLICY
•
Photo ID Re-prints are available on Thursday, at no charge to student.
•
There is an $8.00 fee for RUSH requests. RUSH requests are available during regular photo
ID service hours on Monday, Tuesday, Wednesday, and Friday.
•
To request a re-print, the student must provide a second photo ID (i.e. Driver’s License,
Passport, State ID Card, etc.) for verification purposes. NO EXCEPTIONS!
(Rev. 09/01/16)
IN-DISTRICT AND OUT-OF-DISTRICT FEES
Enrollment, health, and college service fees are waived for high school students
who reside in and/or attend a s chool within the Chaffey College District. Other
fees such as materials fees, books, and parking must be paid by the student.
Note: Prior to the start of the term, fees must be paid by the date indicated on the Payment
Chart in the Schedule of Classes. If payment is not received, the student will be dropped.
Once the term begins, payment is required at the time of registration. If payment is not
received, a financial hold will be placed on the student’s record.
High school students who reside in California but outside of the Chaffey College
District must pay all fees. High school students classified as non-residents of
California (for tuition purposes) and/or the United States must also pay out-ofstate tuition fees.
(Rev 09//01/16)
APPROVAL FOR CHANGE OF RECOMMENDED COURSES
Term/Year:
 Summer
 Fall
 Spring 20
Student Name:
Chaffey ID Number:
HIGH SCHOOL PRINCIPAL’S RECOMMENDATION AND CERTIFICATION
All information must be completed by the Principal or Designee before Chaffey College can accept this form. Incomplete forms will cause delays in
processing.
This student has permission to take one or more of the following courses in addition to, or in place of, courses previously
approved. The student understands that only a maximum of 8.0 units is allowed.
COURSE TITLE
COURSE NUMBER
Print Name of Principal or Designee
High School Name
NUMBER OF UNITS
Signature of Principal or Designee
City and State
(
Area Code
Date
)
-
Telephone Number
(Rev. 09/01/16
HIGH SCHOOL PARTNERSHIP PROGRAM
APPEALS PROCESS
If a student does not meet the minimum eligibility requirements, he/she may submit a High School Appeals Petition for
Committee review. The student must follow all instructions and provide all required information as stated on the petition
form. A separate petition must be submitted for each term in which the student does not meet the minimum eligibility
requirements. See the information box below for deadline information.
Who is eligible to appeal?
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• High School students currently enrolled in 9 through 12 grade.
For what exceptions can a high school student appeal?
• Special admissions approval
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o Student is currently in 9 or 10 grade
o Student’s overall grade point average is below 2.50
• Permission to register for up to 11.0 units.
• Permission to register for 12.0 units or more. If approved, the student is responsible to pay for all fees associated
with registration, including enrollment fees, for all units.
Important Notice: The benefits and consequences of taking college courses fall upon the student. As such the student, not the parent,
must complete the application and appeals process. The student must assume full responsibility for the decision to participate.
A student may submit a high school appeals petition form to the Admissions and Records Office in
Rancho, Chino, or Fontana after he/she completes the following requirements:
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Apply for admissions online
Submit the completed High School Certification & Parental Advisory and Waiver of Liability Forms
Submit a current official high school transcript in a sealed envelope or sent electronically via Docufide
(Parchment)
Complete Assessment and High School Counseling Group (HS SEP) Workshop
The student must obtain and attach the following documentation to the high school appeals petition
form:
Typed-written statement from the student explaining why he/she wants to attend Chaffey College, reason(s) for
requesting an exception, and why an exception should be granted. (The Committee will not accept handwritten
statements.)
2. Copy of the student’s Chaffey College assessment results.
3. A letter of recommendation on school letterhead from the High School Principal, Counselor, or other designee
verifying the following:
a. Student has demonstrated academic strength and the ability to be successful in college
b. Student is mature enough to assume full responsibility as a college student.
1.
A student may submit a high school appeals petition in the Admissions and Records Office in Rancho, Chino, or Fontana, after clearing all admissions
and counseling requirements. The appeals form must have the required documentation attached. The appeals form can be found in the High School
Registration Packet.
TERM
Spring 2017
TERM BEGIN & END DATES
January 9 – May 17, 2017
APPEAL BEGIN DATE
Tuesday, September 6, 2016
APPEAL DEADLINE
Friday, November 18, 2016
NOTE: The Appeals Committee will not accept appeal forms past the deadline. No Exceptions!
(Rev. 0/16)
OFFICE USE ONLY
Registration Date:
 AOC completed  HS Certification Form  Parental Advisory/Waiver of Liability Forms  HS Transcript
Received by/Date:
 PERC Updated
Notification due by:
HIGH SCHOOL STUDENT APPEALS PETITION
CHAFFEY ID NUMBER:
STUDENT NAME:
E-MAIL:
LAST
FIRST
M.I.
HIGH SCHOOL:
IMPORTANT NOTICE TO STUDENT
•
•
•
•
•
Submitting an appeals form does not guarantee approval to attend Chaffey College through the High School
Partnership Program.
High school appeals information is reviewed by committee and the committee’s decision to approve or deny is
final.
Students are notified by e-mail of the committee’s decision. Send an e-mail to admissions@chaffey.edu if you
do not receive an e-mail by the date indicated above.
Retain your copy of this form for future reference.
If approved, the student must register in person in the Admissions and Records Office in Rancho, Chino, or
Fontana by the deadline to add the approved course(s).
o If you are waitlisted, bring the Add Code to the Admissions Office for processing by the Last Day to
Add the class in question. Fees are due at the time of registration.
REASON FOR PETITION:
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I have not completed the 10th grade. I am currently in the
grade.
My 9-12 grade overall GPA is too low. GPA is:
.
I want to take up to 11.5 units as a high school student.
I want to take 12.0 units or more and will pay all fees related to registration.
I am requesting special admissions and/or an exception to a current admission policy for high school students as
indicated above. I have attached the following required documentation:
 Typed-written statement
 Copy of Chaffey College Assessment Scores
 Recommendation letter from Principal or designee on school letterhead verifying academic strength,
college ability, and maturity to assume responsibility as a college student.
Student’s Signature:
Date:
TO BE COMPLETED BY COMMITTEE MEMBERS ONLY
COMMITTEE ACTION:
 APPROVED
 DENIED
(Note: Committee’s Decision is Final)
COMMENTS:
SIGNATURE:
DATE:
OFFICE USE ONLY
E-mail sent to student by/date:
 PERC Updated
 Account Re-billed (12.0+)
(Rev. 09/01/16