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 Type the following URL in the address bar: poi, . Ines L a Suggested Sees 0:1 Web Shea Galley Cum.. Ceedit S... II Crfil lei I I; Mountain View Ci College econnect.dcccd.edu RS Nand North take College College 1 ■ 1111i ■ Connect mil Dallas County Community College District sweetest* nem cm. swam Nees MN! Vas t Mos Payment. fweleseelemw les*elawSshed* eConnect Main Menu eConnect is a web interface that provides a variety of online services to DCCCD students, faculty, and staff. Click on the Current Credit Student Menu future Student Menu NOTE: eConnect hours of operation are 9AM IAN CST unless otherwise noted. Select a menu on the right and then an action from the menu. you will be prompted to log M if needed 0 Centlaam,F.dicationlIH*Tnn... Stedeateleou Faculty menu I'm New to ef onnee What's My Password , Employee Menu getenhon Alen .01PA reps: d«td edu P eConned Current (rt.< P. ' He Edit bevy fluent., jools Bele yy. econset Current Credd S. Suggested so Psookhaven Csidal Valley Festfiekt College c,C4IME. Cnlleac Fl Centro Collote Mountain View North I ake Ftk hiand Volley; College GOIr2 Dallas Colleges Online Connect A Dallas County Ilml Community College District VAR.: Get Answers I Contact U. l eConnect Menu Flamm Vardeat Men. Credit Staid Mean tens Stmetent eConnect Current Credit Students aCcrwact Mar. Cun.ernt Ovasirt fludenta Prepare to Register GIVE US YOUR FEEDBACK My eConnect Account mot chance Password Update MO Challenge Ouestion Foroot/Reset My Password Get Mu Student/Prnolovee In Online Recustration Reaultements Find Credit Classes MEW.) Eat CounisdlMttriagitat Click on the Pre Assessment Video link MARK TOUR CALENDAR Course OestrintIons Transfer Information pre -Assessment Video Mete lade Help Register for Classes Am I Ellaible for Online Registration plan Mu grhedulenteotster Content Reoistration Find Classes & ReOleter/.dal Once Classes Print Me Refe.igt Duo My Books Make a Paynagg eEr dsccd acs eCormsett Curve's/ Creda S. Brooktswen College C Suggested Sites °shit Valley College THINGS TO KNOW IlgiatowserPCChesklIst NEW: eConnect "Find Credit Classes" provides faster searching and schedule building. More Info° Mc Messages PCCCO Prnereencv Alerts Informabon Shock My Grecleg (GPM My Class Schedule dx_CIass ,therloIt picture shown) TIP' - IM New to eConnert TIP' - What's My Pdssword , My Personal Information Then select Eastfield or Richland FYI:Smart code idendges Sommer term gessions More Info° JI$ Kaned Pre-Assessment Neb. Slice Kellen Lastfield Cl Cent, . MSISOLOO View ll.CAlegr• C3ftlO QOge 7k North Lake Colleoe Richt urt w College 11,11115 Colleges Online Connect rs I Contact Us I eConn-ect Menu rutwesteifreosew toes student now WW1 Student Mew taklIthr new tmpkyee Mean Oecaeaektrees xnNuk , stake eConnect Future Student Menu Phase natetNalthevideoma take . few secondsto load Watch the video and then Click on Continue to Assessment (no ice W. A dyed edu r Fk Ian Vim Esvemo Ie. Seg...., Current:v.,. (Si 0,1 hi, ell A- r CX Heir Web Slice Cell. SuggewedSam Cod, Volli•y Leh ell., ri centto College Noah Lake College Mountain View ()Avg° Rkhland E Air], eConnect ec„.„.—. cog nr Dallas County swii Community College District Credo oder. Mee cut Answers COOtect u. Le. Ciarsalate. Log In Students Please enter your seven digit Student ID number password (case sensitive,. and pros S Employees Please enter your Login ID (same as your desktop), password (case sensitive). a Submit SS log in Fleece leg in to complete the Pre - esseesment Pule. StuvientiEmpioyee 10 password ShOW My Password hint 7 you have previously set woof/ass... ie.. Password Potato saw Hint SUBMIT torrootos ototteros to tiro Duro Teo... Login to your eConnect You need your DCCCD ID# and password (if you do not remember your password you will need to click on Forgot/Reset my password. If you reset your password please use the following: gisd123456 (123456 will be your GISD student ID) Add a password hints that says "gisd typed in front of my gisd id#" lorrt=nor.422::7 "=" . 'S==•C i • C X 17,10,,1,0 e0rne0Qu., • dcadadu .1) tle Ess view r avontc Took to, Help ,5 Konnect Current Creche S... e Sega.. Sites 2 Web Slice Iirookhavr'n7 , .i711 I astheld Fl Crntro Mountain View North lake College College College • I le l Lis e i i I leg. e, .li l y Italia, County la Community College District teed' Me. .o.. eConnect Get an... I co... us credo Stotler. He.. eetteeeet .eror rer9 Out ISOIOr Credit Student Click to "check" that you watched the video rwe. saw. ay. horeree•oemoot Then click on Submit Pre-Assessment Qulz I certify • ve watched the Pre-Assessment Video SUBMIT rat I p.m rwpaot ForotoTeres PO, tser errortets I Coat I rettle VI*. Menu I e.o.m.. Now I tea ON .„: Tile Edit Yam f a.orrtes Doh Iderp „t r.a Kong...Cu/ret Creed Suggested so. •• wee Orte Brookhaven cedar Valley F astf gild Colleen. C.oLltwg Collet,* Fl Cutstro MountainVbeye North, l ake Coll** ColleMe Co IFS , Rkhland cOilMX IliallitsColleg link , eConnect IA Dell. County la Community College District FAQ*: Set Answers I contact us I crium student nem/ I egonne. Menu I Lag O. Confirmation Page 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 1. If 31 • 7 - St , then 67- o , 2. (3.eyT • 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