COLLEGE CREDIT PLUS CHECK SHEET

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1 COLLEGE CREDIT PLUS CHECK SHEET Student, please be certain all steps are completed prior to turning in your CCP packet. All completed packets are due to the Counseling Office no later than March 11, If you need help in completing any forms, please sign up to see your counselor. REMEMBER, INCOMPLETE PACKETS WILL BE RETURNED TO YOU For students taking courses at PHS 1. If you are taking a Stark State Course for the first time, you must complete the online Stark State CCP Application. Write the date you submitted your application 2. If you are taking CCP French or CCP Spanish for the first time, you must complete the online Kent State-Stark Campus CCP online application. Write the date you submitted your application 3. If you have already taken a CCP class through KSU Stark, you must complete a returning Student form (found in the counseling office) 4. Course selection form is complete and includes all signatures, test scores and selections. Each line must be completed with information or N/A (not applicable) 5. Double check that you have met the pre-requisites for the classes you are selecting. You will not be permitted to take a class if you have not met the pre-requisites. 6. If additional test scores are required, the scores (Compass, ACT or SAT) must be attached to your Packet 7. Your Stark State ID is written on each enrollment form and course selection form 8. Your parent signature is on the front of the course selection form, the release form (two places) and Enrollment forms (fall and spring). 9. You have completed the top portion of each enrollment form and signed (fall and spring) leave the middle section BLANK 10. You have completed and signed the college (KSU/SSC) release form 11. Your parent has signed and turned in a CCP Intent form to the Counseling Office on or before April 1, 2016 Write the date you turned in your completed CCP packet to the Counseling Office FOR STUDENTS TAKING CLASSES ON THE COLLEGE CAMPUS 1. If you have not previously attended the college/university, you must complete the college application 2. You are responsible for requesting your transcript and test scores be sent to the college/university 3. You and a parent/guardian must set up an appointment to see your high school counselor to review the policies and procedures prior to April 8, It is your responsibility to give your counselor your fall college schedule before you leave for summer break. Date you submitted your college application Date you are and your parent/guardian are to meet with your counselor

2 COURSE REQUEST FORM You must have a Stark State ID to enroll in a CCP Teacher Academy, Science, English, Communication, Business, Math or Social Studies Course and have completed a Kent State Stark application or returning student Kent State application for all World Language CCP courses Student Name Current Grade Level PARENT SIGNATURE ACT Math Score (22) ACT English (18) COMPASS Reading (80) COMPASS Writing (70) COMPASS Algebra I (52) Foreign Language Placement Test Students must meet the scores as listed in the course description. The above scores are considered the college cut scores indicating college readiness Students enrolling in a Stark State CCP Course; My Stark State Student Number is: I am returning to Stark State (check) I am a new student to Stark State and applied to Stark State on: Students enrolling in a KSU CCP Course; I am a new KSU student and applied to KSU on: I am a returning KSU student (check) I am returning Dual Enrollment student. I have completed/am taking/ the following courses: Check the course bulletin for college course description and prerequisites when the course is offered during the school year. The College course number is in parenthesis. All courses except where noted are Stark State College semester courses. If you have a Stark State ID number, you do not apply again to Stark State *denotes an all year course SCIENCE (Stark State Application) Medical Terminology (3 credit hours, BIO125) EMT Basic (7 credit hours, EMS121) Med Tech students only General, Organic and Biological Chemistry (4 credit hours, CHM121) Organic and Biochemistry (4 credit hours, CHM122) College Physics 1A and 1B (2 credit hours each PHY121A, PHY121B)* Physical Geology (3 credit hours, GEO141) SOCIAL STUDIES (Stark State Application) US History I (3 credit hours, HIS121) US History II ( 3 credit hours HIS122) not available Psychology (3 credit hours, PSY 121, online course) not available Sociology (3 credit hours, SOC121, online course) Cultural Diversity (3 credit hours, SOC225, online course) Ethics (3 credit hours, PHL122, online course) Political Science (3 credit hours, PSC121, online course TBD) ENGLISH (Stark State Application) English Composition I (3 credit hours, ENG124) English Composition II (3 credit hours, ENG231) British Literature (3 credit hours, ENG234) American Literature (3 credit hours, ENG237) Students are encouraged to take ENG124 AND ENG231 Teacher Academy students only (Stark State Application) Community and Family Based Programs (3 credit hours, EDU223) Child Development (3 credit hours, EDU131) Introduction to the Teaching Profession (3 credit hours, EDU130) The Exceptional Child (3 credit hours, EDU225) COMMUNICATION (Stark State Application) Effective Speaking (3 credit hours, COM121) online MATH (Stark State Application) College Algebra (4 credit hours, MTH125) College Trigonometry (3 credit hours, MTH130) Statistics (3 credit hours, MTH124) Students are encouraged to take MTH125 AND MTH130 BUSINESS (Stark State Application) Business Administration (4 credit hours, BUS121) Micro-economics (3 credit hours, BUS221) Principles of Management (3 credit hours, MGT121) Principles of Marketing (3 credit hours, MKT121) College Success Skills (3 credit hours, IDT115) WORLD LANGUAGES (KENT STATE UNIVERSITY-STARK CAMPUS) Intermediate Spanish I (3 credit hours, SP28201) Intermediate Spanish II (3 credit hours, SP28202) Elementary French II (4 credit hours) FR13202 Intermediate French I (3 credit hours, FR Intermediate French II (3 credit hours, FR23202) When taking SP28201, students are encouraged to take SP28202 When taking FR13202, students are encouraged to take a FR23201 Students taking CCP French or Spanish for the first time will need to complete the KSU online application

3 RELEASE FORM School Year School Officials: Having been informed by local school officials, who include the counselor and/or principal in a school wide group meeting and having received appropriate and adequate counseling regarding the Dual Enrollment Options Program/College Credit Plus program as called by law, we the undersigned, choose to do the following: We wish to participate in the College Credit Plus program for the school year at Perry. I understand that it is the final decision of the college to accept/deny my application I understand that if I take these courses for college credit, I will begin my college transcript I understand that if I earn an F as a grade OR drop the course after the tenth day of class I will be required to pay all costs associated with the dual enrollment course and a hold will be placed on my transcript and diploma until the fee is paid in full I understand that if I fail to return the College text book I will be required to pay for the book and my transcript and diploma will be held until the fee is paid in full I understand that I am to return my textbook in the same condition I received it and failure to do so will result in paying a repair fee and my transcript and diploma will be held until the fee is paid in full. Student Signature and Date Parent/Guardian Signature and Date Records Release Form Dual Enrollment Release of Transcript- In compliance with the Family Rights and Privacy Act of 1974 and being legally responsible for (student name) I (parent/guardian name) Give permission to Perry to release school records consisting of: Student Name, Date of Birth, Transcript of Grades, Credits earned, Attendance Record, Standardized test scores, name of parent/guardian, and other relevant information required/requested by the college or university, OGT scores, AIR scores and college placement scores. I understand that these school records will be sent upon request during/ for the school year. I give Perry permission to post my grades on Pinnacle and share my grades/information with (parent/guardian name) whose date of birth is. I also give Stark State College and Kent State University permission to release my student s ID number, credit/s earned and grade/s earned to Perry. Student Signature/Date Parent/Guardian Signature/Date

4 College Credit Plus Letter of Intent to Participate in College Credit Plus Please Print Date After April 1, you will need Permission from the School Principal to Participate Student Name Parent/Guardian Name Home Address Parent Phone Number (Day) (Evening) Parent Address Student Contact Information School Current Grade Level I would like to declare my intent to participate in the College Credit Plus program at Perry. I understand that signing this form does not require that I participate during the coming school year ( ) and I may decide not to participate without consequence. I also understand that it is my responsibility to notify my school if I do not gain admission to my selected institution of higher education or choose not to participate for some other reason. In addition, I certify that I have received counseling about the College Credit Plus program concerning the rules and regulations for both my school and the college, and that I understand my responsibilities, the benefits and possible risks of participating in the College Credit Plus Program. Student Signature Date Parent/Guardian Signature Date

5 KENT STATE UNIVERSITY- STARK CAMPUS COLLEGE CREDIT PLUS FALL CLASS REGISTRATION FORM Before you complete this class registration form, please make sure that you have completed the following: 1. Applied to the college (first time student) or Renewal Form (returning student) 2. Submitted your high school transcripts (first time student) 3. Submitted your ACT or SAT scores and FLPT score (if applicable) 4. Attach PHS Enrollment Form 5. Student Information Release Form Student Name Telephone Number Enrollment Term: FALL 2016 PERRY HIGH SCHOOL Course section below will be completed by the counselor Date of Birth Today s Date CRN SUBJECT NUMBER COURSE TITLE CREDIT HOUR TIME DAYS Total Credit Hours Grade Point Average (GPA) Graduation Date I have advised this student and his/her parents or legal guardian of the available options and ramifications involved in early college admission. Our school district approves of this student enrolling in courses at Stark State College. Counselor Signature Student/Parent Agreement We have received counseling services at our high school and are fully aware of the possible risks and consequences of participating in an Early Admissions Program, including paying the cost of tuition and books should the student not complete or pass the coursework. Student Signature Parent Signature FOR OFFICE USE ONLY Processed Date Initials This form is used only for CCP French and Spanish World Languages

6 KENT STATE UNIVERSITY- STARK CAMPUS COLLEGE CREDIT PLUS SPRING CLASS REGISTRATION FORM Before you complete this class registration form, please make sure that you have completed the following: 6. Applied to the college (first time student) or Renewal Form (returning student) 7. Submitted your high school transcripts (first time student) 8. Submitted your ACT or SAT scores and FLPT score (if applicable) 9. Attach PHS Enrollment Form 10. Student Information Release Form Student Name Telephone Number Enrollment Term: SPRING 2017 PERRY HIGH SCHOOL Course section below will be completed by the counselor Date of Birth Today s Date CRN SUBJECT NUMBER COURSE TITLE CREDIT HOUR TIME DAYS Total Credit Hours Grade Point Average (GPA) Graduation Date I have advised this student and his/her parents or legal guardian of the available options and ramifications involved in early college admission. Our school district approves of this student enrolling in courses at Stark State College. Counselor Signature Student/Parent Agreement We have received counseling services at our high school and are fully aware of the possible risks and consequences of participating in an Early Admissions Program, including paying the cost of tuition and books should the student not complete or pass the coursework. Student Signature Parent Signature FOR OFFICE USE ONLY Processed Date Initials This form is used only for CCP French and Spanish World Languages

7 CCP TRANSCRIPT REQUEST FORM Counselor A-C Mr. Lacourt D- Hn Mrs. Crim Ho-Mf Mr. Lautensleger Mg- So Mr. Miller Sp-Z Mrs. Bowersox Student Name Current Grade level I have applied to the College Credit Plus program at (Name of college/university) on (date application submitted). Please send my transcript to this institution

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