Form: PA-3021
Early College / Middle College High Schools
District:
Count Date:
Building/Program:
This form is for identifying pupils enrolled in an early college or middle college high school program operated by the district or
another district and for which the district is claiming FTE. These high school programs are designed to allowa pupil to earn a high
school diploma while also earning an associate’s degree, certificate of completion, or up to 60 transferable college credits toward a
four year degree.
**Important: Attach Form C-1 showing the list of pupil(s) enrolled in an early college/middle college high school program.
Provide information requested below
Name of Early College or Middle College
High School Program
Name of Principal/Director
Include Contact Information
Physical Location
of Program
Where Classes are Provided
Post-Secondary
Institution Providing
Instruction