High School:Program: Accel MOWR

Armstrong State University requires that each student interested in dual enrollment first meet with his/her high school counselor prior to submitting an official application for admission. All involved in this decision must meet to determine if the program will fit the student’s needs for graduation and high school involvement. Student, guardian, and high school counselor must complete this agreement and return it as part of the dual enrollment admissions application. (This form is new beginning Fall 2011 and replaces the previous parental consent form and high school counselor recommendation letter.)

Student:

Printed Name: Date:

High School:Program: Accel MOWR

(Circle One)

Parent/Guardian:

Armstrong State University requires that a parent/guardian initial on each line indicating his/her understanding and agreement with the following statements.

I certify that the information reported on any documents or writingsassociated with this admissions application are true, correct, and complete to the best of my knowledge.

I authorize the release and exchange of information between Armstrong Atlantic State University and my student’s high school counselor.

I consent to my student’s participation in the Dual Enrollment Program at Armstrong Atlantic State University.

I agree to pay any fees not covered by my student’s dual enrollment scholarship program.

High School Counselor:

Armstrong State University requires the high school counselor to initial on each line indicating his/her understanding and agreement with the following statements.

This student meets the minimum GPA and standardized test score requirements necessary to qualify for his/her dual enrollment program (Accel or MOWR).

This student is on track to graduation and will be able to meet necessary high school college prep requirements while dual enrolled.

This student possesses the level of maturity and motivation necessary to excel in college level coursework.

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High School Counselor (cont.):

Please list all academic requirements this student must complete for high school graduation. Place a checkmark next to each course requirement the student plans to complete while enrolled at Armstrong.Also, indicate any courses that will not count towards high school requirements.

Course/Subject Area Carnegie Units

Indicate below the sequence in which the student plans to complete his/her requirements. Please provide the course name and number.

Ex: Advanced Composition 23.03400

Fall ______Spring ______

Please sign below indicating that the above information is true and correct to the best of your knowledge at the time of application.

Student (Print): Date:

Student (Signature):

Counselor (Print): Date:

Counselor (Signature):

Parent/Guardian (Print): Date:

Parent/Guardian (Signature):