Request for Admission Students Under the Age of 18 form - glendale ...

Request for Admission
Students Under the Age of 18
Eligibility:
Admission to Glendale Community College may be granted to any person under the age of 18 who achieves one
of the following:
1. A composite score of 93 or more on the Preliminary Scholastic Aptitude Test (PSAT)
2. A composite score of 930 or more on the Scholastic Aptitude Test (SAT)
3. A composite score of twenty-two or more on the American College Test (ACT)
4. A passing score on the relevant portions of the Arizona Instrument to Measure Standards (AIMS) test
5. Completion of a college placement test designated by the Community College District that indicates the
appropriate college level for the course
6. Is a graduate from a private or public high school or possession of a high school certificate of equivalency
Enrollment in vocational courses will be considered on a individual basis if the student meets the established requirements
of the courses for which the student enrolls and enrollment is in the best interest of the student.
NOTE:
Admission shall be considered on an individual basis and upon written concurrence of the student, parent or guardian,
and Director of Admissions, Registration and Records. The final decision for admission and enrollment to any
class will be determined by the Director of Admissions, Registration and Records in consultation with the department
chairperson. Students must renew admittance eligibility each semester they wish to be enrolled in the Admission
for Students Under the Age of 18 program. Students in the Admission for Students Under the Age of 18 program are
expected to be fully acquainted with and comply with all current published policies, rules, and regulations.
Required Admission Documents:
Students under the age of 18 requesting admission to Glendale Community College must submit the following
documents:
q Request for Admission Students Under the Age of 18 form
q Student Information Form (SIF)
q Unofficial high school transcript—including courses, grades, courses in progress, AIMS test scores
q Letter from the student stating reason(s) for enrollment
q Placement test scores for placement in English, reading or mathematics courses
(ASSET, COMPASS, CELSA)
q Original copy of ACT, PSAT, or SAT test scores
To be Completed by College Official:
q ACT Scores__________________________
q PSAT Scores_________________________
q SAT Scores__________________________
q AIMS Scores_________________________
q ASSET Scores____________________________
q COMPASS Scores_________________________
q Accuplacer Scores_________________________
q Vocational Scores_________________________
q Approved
q Not Approved Director, Admissions, Registration and Records Date
For additional information call 623.845.3313.
continued on back . . .

To be Completed by the Student: q Fall q Spring q Sum I q Sum II
Year
Student Name
Age
Student Identification Number/Social Security Number
Home Address
SAIS (Student Accountability Information System) Number
City, State, Zip
( )
Home Phone #
Name of School Attending Grade Expected Graduation (mo./yr.)
Course Number Section Number Title Credits
Total Credit Hours
I agree to the exchange of academic information between the participating institutions, including but not limited
to college grade reports, transcripts, and any other pertinent documents. I give permission to release any and all
Glendale Community College information to my parents and/or legal guardian.
Signature of Student
Date
To be Completed by the High School/Junior High School District Official:
I recommend the student named on this form for Admission - Students Under the Age of 18 to Glendale Community
College for the semester, 20 . I believe the student will profit from concurrent
enrollment. It is also understood that the student will receive college credit for successfully completed course
work. The student has a cumulative grade point average (G.P.A.) of on a system with
a class rank of / . Will high school / junior high school credit be granted q Yes q No
Signature of High School / Junior High School Counselor / Administrator
Date
To be Completed by the Parent or Guardian:
I give permission for
to enroll as a student at Glendale Community College
during the semester, 20 . I understand that although he/she is under 18, he/she is entering an
adult environment. As a college student, I understand that my son/daughter:
___Will be establishing a college academic record and will be required to report enrollment at GCC to future
colleges or universities.
___ Will be responsible for knowing and following college policies published in the General Catalog & Student
Handbook and Schedule of Classes.
___Will be subject to the course requirements, grading standards and attendance requirements established by
the instructor in the course syllabus.
___May, at times, come in contact with course subject matter of a mature and sensitive nature.
___May be using unfiltered computer systems, common to a college environment.
___Will be protected under the Federal Education Rights and Privacy Act and information about academic
performance, attendance and educational records cannot be shared with a "parent" as defined by FERPA
without the students written permission, or documented evidence that the student is a dependant according to
the Internal Revenue Code of 1986, section 152.
Signature of Parent / Guardian
Date
For additional information call at 623.845.3313.
11/01/07