GtSD
Garland Independent School District
Dual Credit Enrollment Check-List
GISD#:
Name:
rm Dallas County
UM Community College District
Year of Graduation:
DOB:
DCCCD#:
(DCCCD# is the student identification number assigned after you complete the application)
Student Cell #:
Current School:
Parent Phone#:
Parent Name:
Student Email:
VERY IMPORTANT for students to use their own personal email address. NO PARENT emails. You will have to
know the email address on your account to reset your password if you forget it.
NOTE: Black or Blue Pen must be used on all forms. Read instructions & check-off as completed.
Complete the Online DCCCD Application
Go to https://wwwl.dcccd.edu/stuapp/ . Use the Dual Credit Application Help Sheet to complete
the application. You MUST use the student's email address in the application. AS SOON AS YOU
GET YOUR STUDENT ID (WHICH IS YOUR DCCCD#), WRITE IT ON THIS CHECK-LIST AND MAKE
NOTE OF IT FOR FUTURE USE. If you were not born in the U.S, complete the Affidavit of
Residency Form. www.eastfieldcollege.edu/as/DualCredit/Affidavit.pdf . The Affidavit form must
be notarized.
Set-up an eConnect account
Please see instructions for setting up your eConnect Account in this packet. Please make sure
you add a detailed password hint on eConnect. You will need to know the email on file to reset it.
Complete the Emergency Treatment Form.
Parents should print their name in the form, complete emergency information and sign it.
Complete the FERPA Release of Proxy Form
The Parent/Guardian listed on this form is the "Proxy." You and parent must sign this form.
Complete the Proof of Bacterial Meningitis Immunization Form
Both student and parent must sign this form. You need to attach a copy of your shot records. You
can get a copy from your school nurse or your family doctor.
Attach a copy of your Application Admission Results from the online application — This is what
you printed when you completed the online application and received your ID#.
Initial here that you completed the PreAssessment Activity: Date completed:
You must first watch the video and then complete the sample quiz.
Dual Credit Acknowledgment Form
Initial by each item. Both student and parent must sign this form.
Complete the High School Enrollment Form. You only have to write your DCCCD# (student ID#
for Eastfield or Richland), sign, and have your parent sign. Leave the College Course Name list
section blank.
Dallas County
A
11111 Community College District
GISD ID#:
DCCCD ID#
Tips for Successful Completion of the DCCCD Online Admissions Application
For High School Students
1.
Go to https://wwwl.dcccd.edu/stuapp/newuser_hs.cfm (except for Rising Star). Plan to dedicate 30-40 minutes for
application completion and confirmation. Read each section of the application carefully!
2.
Complete the User Information section. It is critical that you provide Eastfield/Richland College with an email address
that you check frequently! Always use the same email address in your communication with Eastfield/Richland
College. Please indicate that you are seeking admission as a Dual Credit Student on the application. Remember to
maintain a record of your student record username and password for future use.
3.
Provide all requested information for Part A: Biographical Information. Although your social security number is
optional and dual credit students are NOT eligible for financial aid, we encourage you to supply it so that your
application can be matched with your test scores and high school transcript. Complete both current street address
and permanent mailing address sections even if they are the same. For the College Plans section indicate which
semester you are applying (e.g. Fall 2015 or Spring 2016) with Eastfield/Richland College in order to earn credits to
Transfer to a University. All sections of Part A, including High School Education, Previous College Work and Texas
Success Initiative must be completed by the student.
4.
Complete all information for Previous College Enrollment, Residency and Acquisition of the High School Diploma. It is
the responsibility of the student to read Part I: Certification of Information, before attaching an electronic signature.
5.
Take the opportunity to review the information submitted on your application and correct as needed before final
submission. Once you have submitted your information, please allow the system to process without additional
keystrokes or actions.
6.
Within 4-5 minutes after application submission, you should receive your DCCCD Application for Admission Results
page; Letter of Acceptance containing your DCCCD student identification number, Pending letter, or unfortunately
response. Immediately print a copy of your Admission Results for submission with your other required dual credit
documents and provide that to either your High School Counselor or Eastfield/Richland College's Dual Credit Office.
7.
Finally, use the link, Setup My eConnect Account, at the end of the document to create your college student account.
Following submitting your online application, please use the link provided to set up your DCCCD College student
eConnect Account using your DCCCD Student ID number from your Letter of Acceptance. It is critical that you use the
same email address submitted on your application to create your eConnect student account. Please keep your college
student ID number and eConnect password private. eConnect is used to check final grades at the end of the
semester and to request your Eastfield/Richland College transcript to send to universities.
Dual Credit Application, eConnect and PreAssessment Help Sheet
1. Go to https://wwwl.dcccd.edu/stuapp/
2. Click on the link Admissions Application for High School Students
3. Fill in your information
a. First, Middle & Last name
b. Home, Work & Cell number
c. E-mail address & confirm e-mail (This should be the student's email address. Do not use a parent's email.)
d. Please choose one of the following: / currently live in Texas
e. Please indicate on what basis you are seeking admissions: Dual Credit/Concurrent
f.
Create a username
g. Create a password & confirmed password
h. Click on Create Account & Continue
4. Page I — Part A
a. What semester will you begin taking classes: choose current semester
b. Reason for attending university: two year degree
c. I plan to take courses primarily through:
i. Pick Eastfield College if you attend LCHS, SGHS or RHS
ii. Pick Richland College if you attend SHS, NGHS, NFHS, or GHS
d. Your social security number: If you have an social security please click on: The following is my social security It: add your social
security # OR if you do not have one or do not know it please click on: I do not have a Social Security #
e. Date of birth
f. Address, City, State & Zip code
g. Please choose a county: Dallas County
h. How long have you lived at this address: Choose the number of years and months
Permanent Mailing address: Do not fill out, leave it blank
i.
Place of Birth: City, State & Country
j.
k. How do you identify yourself: Ethnicity, Race & Gender
I. What is your primary language: choose a language
m. Are you a U.S. Citizen: Yes or No. If you answered yes, scroll down to Military-Veteran Status. If you said no, fill out the
questions below
n. Military-Veteran Status: "None of the above"
o. Emergency Contact: Name of person in case of an emergency & contact #
p. Did you take Tech Prep Courses: No
q. Click on: Save & Continue
5. Page II — Part A (cont.)
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Which of the following best describes your High School Education: / am or will be a High School Graduate
What year did you or will graduate from High School: Enter the year of graduation
Which best describes your High School or International Equivalent: Click on Texas high school. Select from All Texas High
Schools & scroll down to choose your school name
Did you take Tech Prep course for college credit: No
Will you graduate from a Texas public High School with the Recommended or Distinguished Achievement Program: Yes
Did or will you graduate with an IB diploma: No
Previous College Work: Click on / have no previous college experience
Scroll down all the way towards the bottom of the page and then click on I have not taken any of the test listed above and I
am not claiming an exemption
Please click on "1 have not taken any test" even though you might have exemptions scores. We have to verify first.
Click on Save & Continue
6. Page III - Part B
a.
During the 12 months prior to the term for with you are applying, did you attend a public college/university in Texas:
No and
skip to Part C.
7. Part C
a. Are you a Texas resident: Yes
8. Part D
a.
b.
Did you live in Texas or will you have lived in Texas the 3 consecutive months leading up to high school graduation or
completion of the GED: Yes
When you begin the semester for which you are applying, will you have lived in Texas for the previous 12 consecutive months:
Yes
9. Part E
a. Do you file your own federal income tax as an independent taxpayer: No
b. Are you claimed as a dependent or are you eligible to claimed as a dependent by parent: Yes
c. If you answered "No" to both questions above, who provides the majority support: Parent or Guardian
d. Click on Save & Continue
10. Page IV — Part F
a. Skip part F
b. Click on Save & Continue
11. Page V Part H
a. Skip part H
b. Click on Save & Continue
12. Part V Part I
a. Click on the box towards the end of the page "By checking this box, I am attaching my electronic signature"
b. Click on Save & Continue
13. Review Application
a. Review all the information you typed in or clicked on and make sure everything is correct. Make changes if needed.
b. If everything is good then click on Save & Continue
14. Submit Application
a. Click on "Submit My Application"
15. Application for Admission Results
a. You will get a Letter of Acceptance. WRITE down or TAKE A PICTURE of your ID number & print out the acceptance letter. It
should get a 7-digit # as your Eastfield ID#.
16. Towards the bottom of the acceptance letter click on Set up My eConnect Account
e-Connect
1. Towards the bottom of the page of the acceptance letter click on "Set up My eConnect Account"
a. Enter your Last Name, Birth Date, Email Address, and Student ID Number. Email address must be the same one you enter on
the application and ID# is the number given to you when you completed the application.
b. Click Submit
2. Create Password
c. Create a password & confirmed password. Make sure to
d. Password hint: enter a password hint in case you forget your password
e. Challenge Question: Choose a question and enter an answer for security
Case sensitive: Click on the box Enable Enhanced Security
f.
g. Click Submit
3. Confirmation
h. You should get a confirmation page saying congratulations you have created an account
i.
Do not log in
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Pre-Assessment Activity
Go to www.econnect.dcccd.edu
Click the Current Credit Student Menu
Under "prepare to register" click on the link "pre-assessment video".
Video Links: Click on either Eastfield College or Richland College and Watch the video.
Once you completed watching the video click on "continue to assessment" below the video.
You will be prompted to login to your Student eConnect Account
Click the box next to the information that indicates "I certify that I have watched the Pre-Assessment Video" and click submit
Complete the quiz (Make sure you write down your answers in case the computer times-out and you have to start over)
Once you complete the quiz you will get a confirmation list that shows you the correct & incorrect answers
Print your results and Click Log Out when you are finished
111111 Dallas County
GISD ID#:
DCCCD ID#
Community College District
Consent to Emergency Treatment
Dallas County Community College District ("DCCCD")
Under Age 18
Printed Name (Last, First, Middle)
DCCCD on behalf of
Dual Credit
Program
Date of Birth
College i s an educational institution in which
a student, is enrolled and t h e College has
received written authorization to consent to emergency medical treatment from a person having the right
of consent as follows:
(Print student name),
(Print parent name), the
(relationship to student) grant
the College permission to authorize emergency medical treatment for the above named
student. This authorization is effective until the student's 18 th birthday, which is
[month & year]. The undersigned is responsible for all
medical costs associated with this authorization.
Signature of Parent or Legal Guardian
Date
Work No.
Cell Phone
Home No.
In the event that parent or legal guardian cannot be reached, please contact:
Emergency Contact #1:
Name
Relationship
Work/Home No.
Relationship
Work/Home No.
Emergency Contact #2:
Name
Voluntary Health Information
Allergies:
Current Medications & Dosages:
List health problems you believe the college should be aware of in case of emergency:
EMI Dallas County
GISD ID#:
DCCCD ID#
Community College District
FERPA Release and Registration by Proxy Form for Dual Credit
The Family Educational Rights and Privacy Act
MI
First Name
Last Name
Mailing Address
DCCCD ID No.
City, State & Zip
Street No. or P.O. Box
Phone
Email
Dual Credit students enrolled in college classes are protected by the Family Educational Rights and Privacy Act (FERPA)
of 1974. In order to comply with federal laws dealing with the confidentiality of official student records (FERPA), the
student must sign a written release authorizing registration by a proxy and/or authorizing the release of the student's
educational information to the proxy. If the student wishes to be registered by the parent(s) or allow parent(s) to have
access to certain educational records this form must be completed, signed and submitted to DCCCD. The student has the
ultimate responsibility to make sure the registered courses are correct. The student may cancel the release at any time by
submitting another FERPA form. The release is valid until the date of the student's High School Graduation as confirmed
on the final official high school transcript or when an updated form is received by DCCCD. Anticipated High School
(Month/Year)
Graduation Date:
AUTHORIZATION TO RELEASE EDUCATION INFORMATION AND/OR REGISTRATION BY PROXY
Admission —Includes application and documents
received for admission status, documents
pending, and conditions of admission, correction
of address and telephone numbers and signing
documents on my behalf
Academic Records — Includes grades received.
GPA, and academic progress
Registration — Includes current enrollment,
dates of enrollment, enrollment status,
residency status, semester attending and
mailing address information
Registration by Proxy — Includes course
selection, obtaining copy of advising report,
adding and dropping courses, and paying
tuition if necessary
Please Print Clearly (P=Parent, G=Guardian, O=Other)
Relationship (Circle one): P G 0
Release to
I
Cancel:
Date of Cancelation
Name - Proxy #1 (This is your parent or guardian)
Relationship (Circle one): P G 0
Release to
Cancel:
Date of Cancelation
Name - Proxy #2
I hereby grant DCCCD permission for the release of my educational information selected above and/or permission for
the individual(s) designated above to serve as the authorized proxy for the selected services above.
Date
Student's Signature
Signature of Proxy #1 (Name listed above)
Date
Signature of Proxy #2
Date
NOTE: STATE ISSUED IDENTIFICATION CARD WITH PICTURE IS REQUIRED FOR BOTH THE STUDENT AND THE PROXY WITH THIS
FORM: Official state driver's license is preferred. Students may submit a high school identification card, but will be required to sign
and print legal name on photo copy.
Office Use Only:
Picture ID Verified by:
Date:
FM Dallas County
holl Community College District
GISD#:
DCCCD ID #
Brookhaven College
Cedar Valley College
Eastfield College
El Centro College
Mountain View College
North Lake College
Richland College
reclistrar-bhct@dcccdedu
registrar-cycdcccdiedu
registrar -efcadeccd edu
registrar -eccdcccd edu
registrar - mvcdcccd edu
recpstrar - nlcdeccd edu
registrar-ricdcccdedu
phone: 972-860-4883
fax: 972-860-4886
phone: 972-860-8201
fax: 972-860-8001
phone: 972-860-7167
fax: 972-860-8306
phone: 214-860-2311
fax: 214-860-2233
phone: 214-860-8600
fax: 972-698-3074
phone: 972-273-3183
fax: 972-273-3112
phone: 972-238-6100
fax: 972-238-6346
Distance Learning students contact: Dallas Colleges Online, registrar-dtc(M.doccd.edu phone: 972-669-6414, fax: 972-682-7071
Proof of Bacterial Meningitis Immunization Compliance
Until December 31, 2013, The Age Requirement For New and Returning Students is under the Age of 30**
Student Name:
DCCCD ID#:
Address:
Date of Birth:
Email Address:
Telephone:
** Effective January 1, 2014, the aqe for an exemption from the vaccine requirement will change from 30 to 22.
Please read and place an "X" in the correct box: sign, date, and submit to your College Admissions Office.
I am claiming a Bacterial Meningitis Vaccine exemption due to health reasons (see section B below).
I am declaring an exemption from the Texas immunization requirement for bacterial meningitis for reasons of
conscience, and have attached the appropriate notarized affidavit form. Texas Department of State Health Services
(DSHS) affidavit can be found at https://webds.dshs.state.tx.us/immco/default.aspx
I have received the Bacterial Meningitis Vaccine within the last 5 years and I have attached an official vaccination record.
My Physician or health care professional has documented my meningococcal vaccine in section A below.
Physician or Other Health Care Provider Must Complete A or B
A. Vaccination Date:
Vaccine Type: MCV-4 0 MPSV-4C3 As recommended by the CDC
PLEASE DO NOT SIGN THE COMPLIANCE FORM UNLESS THE STUDENT
HAS PROPER VACCINES OR IMMUNE TESTS.
(Signature of Physician or Other Health Care Provider)
Please use stamp or print name, office address,
phone number and the state where licensed and
license number.
Date
B. BACTERIAL MENINGITIS MEDICAL EXEMPTION
I CERTIFY, THAT IN MY OPINION, THE BACTERIAL MENINGITIS
VACCINATION REQUIRED WOULD BE INJURIOUS TO THE HEALTH AND
WELL-BEING OF THE STUDENT AND SHOULD NOT BE ADMINISTERED AT
THIS TIME.
(Signature of Physician or Other Health Care Provider)
Date
✓ I understand that I will not be allowed to register for courses in any of the colleges of the DCCCD without the proper
meningitis vaccination documentation as indicated above.
✓ I understand that proof of the vaccination must include the physician or health care professional's signature, the date the vaccination
was administered, the medical facility's stamp and seal, and contact information.
V I certify that, to the best of my knowledge, the above information (including attachments) is true and correct. I also give
my consent for the above immunization record to be entered into my student record.
Student's Signature - REQUIRED
MINORS: Signature of Parent or Legal Guardian Required
Age
Printed Name of Parent or Legal Guardian
Date
if student is under 18 Years of
Date
Relationship to Student
Pre-Assessment Video & Assessment Instructions
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staff.
Click on the Current Credit Student Menu
future Student Menu
NOTE: eConnect hours of operation are 9AM
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Select a menu on the right and then an action from the
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ID: 23.708
Name Tkrir Tyner Creelenore
Thank you for taking the TSIeteAssessment Quiz The cortect answers are Mdicated m greet Any questions you answered incorrectly will show your answer
in red and the correct anew. In green
Mathematics Sample Questions with Answens
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At this point you will complete the assessment.
You may want to write your answers on a
scratch piece of paper. The test will timeout
after 20 minutes if you haven't completed it.
You will have to start the assessment over if
this happens. (you do not have to watch the
video again)
When you finish your assessment you will click
"submit".
You will get this confirmation page.
Garland ISD & Dallas County Community College District
DUAL CREDIT ACKNOWLEDGMENT FORM
Student Name:
GISD ID#:
The Garland Independent School District (GISD) and Dallas County Community College District (DCCCD) partner
to offer dual credit courses for all qualifying GISD students. Dual credit classes are college-level courses and
great consideration should be taken when selecting appropriate classes. Please initial by each item listed
below.
I understand I must pass the required Texas Success Initiative Assessment by the designated
timelines to participate in the program.
I understand I am limited to only two dual credit classes per semester unless I demonstrate
outstanding academic performance. If I am approved to take more than two dual credit courses,
I must maintain a DCCCD GPA of 2.5 or higher to continue taking more than two dual credit
classes per semester.
I understand that my grades in dual credit classes are transcribed onto my official high school
and college transcripts.
I understand that if I receive a final semester grade of W, D, or F in any dual credit course, I may
not be eligible for dual credit classes the following semester.
I understand that if I drop a course after the DCCCD add/drop date, I will receive a failing grade
in the course. I must submit the required withdrawal form to my assigned DCCCD college's Dual
Credit Coordinator by the published DCCCD deadline to receive a W on the college transcript.
I understand that I must maintain a 2.0 GPA at DCCCD and maintain a completion rate of 70% to
be eligible to remain in the dual credit program. Students who withdrawal from dual credit
courses or earn grades of D or F on a college transcript may not be eligible for future financial
aid or may have limited financial aid options beyond high school.
I understand that taking excessive dual credit hours (30 extra hours beyond what is required on
my undergraduate degree plan) may cause me to lose Federal Financial Aid eligibility and/or
cause a tuition price increase at Texas public institutions of higher education.
I understand it is my responsibility as a DCCCD student to utilize the eConnect and eCampus
websites to check my schedules, GPA, grades, advising report, and announcements from the
colleges.
I understand that Academic Dishonesty may result in consequences from both my GISD high
school and DCCCD. DCCCD may suspend my dual credit eligibility and any appeals must go
through the DCCCD college campus process.
I will be limited to 15 hours per semester.
Appeals for DCCCD grades, drop policy, or other DCCCD actions must go through the DCCCD
appeals process as stipulated by the assigned DCCCD college campus.
As a dual credit student, I am a both a GISD and DCCCD student, thus I am entitled to all the
resources at my assigned DCCCD college campus — college library, student services, free
tutoring, etc.
Student Signature:
Date:
Parent/Guardian Signature:
Date:
Revised 7/2015
Graduation Class of:
GISD
GARLAND INDEPENDENT SCHOOL DISTRICT
Student Record Release Authorization Form
DOB
Student
First
Last
ID#
Grade
Middle Initial
High School:
Garland High School
310 S. Garland Road
Garland, Texas 75040
Lakeview Centennial High School
3503 Hayman Drive
Garland, Texas 75043
Memorial Pathway Academy
2825 S. First Street
Garland, Texas 75040
Naaman Forest High School
4843 Naaman Forest Blvd.
Garland, Texas 75043
North Garland High School
2109 Buckingham Road
Garland, Texas 75040
Rowlett High School
4700 Kirby Road
Rowlett, Texas 75088
Sachse High School
3901 Miles Road
Sachse, Texas 75048
South Garland High
600 Colonels
Garland, Texas 75043
Information listed below will be released to the listed person(s)/agencies.
Achievement Test Score*
Grades*
Attendance Information*
Birth Date*
Grade Point Average/Ranking*
Other
Graduation Program Type*
Home Address*
Social Security Number*
Special Education Information
SAT/ACT/PSAT Scores*
Other
TAKS/STAAR EOC Test Scores
Other
*Information automatically included on the
transcript
The information listed above may be released on the named student to:
College/ Universities
Military Recruiters
Scholarship Donors
Do
not send information to:
Employer
Student
Parent(s)
GISD Personnel (as appropriate)
Other
Information may be release by:
•Hard copy by US Postal mail •TRex ' , Electronic Common Application Process
Other, specify
Signature of Parent/Guardian
Date
Signature of Student (18 years or older)
Date
This release is in accordance with the provisions of the Family Educational Rights and Privacy Act of 1974.
Guidance and Counseling Department/Student Record Release Authorization Form
GISD ID#:
111.11 Dallas County
DCCCD ID#
Community College District
HIGH SCHOOL STUDENT ENROLLMENT FORM
PLEASE USE ONLY BLUE OR BLACK INK
This certifies that (Student Name)
, DCCCD#
enrolled as a student at
, is or will be
High School and has permission to concurrently enroll with
College of the DCCCD.
List your College Course Names and complete the checklist
for each course to be taken, pending approval, in the
appropriate semester.
College Course Name(s)
Fall
2015
Spring
2016
SUM I
SUM II
2016
2016
Dual
Credit
College
Credit
Only
1.
2.
3.
4.
5.
I understand I will be enrolling in a college credit course(s) at one or more of the colleges and will be receiving a letter grade that will be recorded on my permanent
college transcript. A numerical grade will appear on the high school transcript for dual credit courses; conversion of grades is the responsibility of the respective
high school. It is the student's responsibility to verify the transferability of courses with the institution of choice.
Eligibility for continued participation in this program requires satisfactory academic performance at the high school; earned grades of A. B or C in all college courses:
and parental and school approval for each subsequent semester of enrollment. A student who earns grades of D or F may not be eligible for future dual credit
courses or may have restrictions. Also, students are not eligible for state or federal financial aid while enrolled in high school. However, because they are recorded
on the college transcript, grades earned for dual credit/concurrent courses can impact a student's future financial aid.
I understand that if I wish to withdraw from my college course(s), it is my responsibility to first discuss this matter with my high school counselor. Also, it is my
responsibility to submit the required withdrawal form to the College Dual Credit Coordinator or College Registrar by the published deadline.
A non-immigrant visa student is responsible for maintaining his/her own visa status. I understand it is my responsibility to verify my status and my ability to take
college courses through dual credit enrollment.
I understand that I MUST be enrolled as a full - time student at my high school, and I cannot enroll in more than two college courses per semester, districtwide, without special permission. Only one dual credit waiver per approved course is allowed. However, a student is responsible for tuition of a repeated course
and costs of online dual credit courses offered outside Dallas County.
I understand that ACADEMIC FREEDOM is practiced at all of the colleges of the Dallas County Community College District. Academic Freedom allows faculty
and students to pursue whatever inquiry they feel is important and to speak about it in the classroom without fear of censorship. I understand that within a college
environment, students may encounter adult language and images, different philosophical viewpoints and belief systems. I understand that appropriate and
essential discipline-specific terminology, concepts and principles are utilized as needed in the classroom setting. All high school students are held accountable
to policies, rules, and regulations of the colleges of the Dallas County Community College District. For more information see \,vww.dcccd.edu
I authorize the college to release my transcript to the above named high school related to my college enrollment.
Student Signature
Date
Signature of High School Official
Parent/Guardian Signature
Date
Title
Date
Signature of College Official
Date
Approval signatures are required for a student to take more than wo college courses per semester (district-wide).
College Chief Academic Officer or Authorized Designee
Date
High School Principal
Date