Concurrent Enrollment Application Packet

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1 Carl Albert State College Concurrent Enrollment Application Packet Office of Admissions & Records 1507 So McKenna Poteau, OK voice fax Sallisaw Campus, 1601 Opdyke, Sallisaw, OK

2 Attach: New students submit the following documents for first-time admissions to CASC and initial enrollment. These documents are submitted at time of first-admissions for concurrent enrollment. Permissions Form Application for Admissions NATIONAL ACT test scores High School transcript High School COURSE SCHEDULE (for upcoming term) Provide social security card or evidence to confirm SSN Provide drivers license or other ID to confirm identity Deliver to: Please know that students must submit their high school course schedule each semester of concurrent enrollment, so that the Office of Admissions may verify the student is enrolling in no more than a combined 19 credit hours of high school and college coursework. Students may file a Petition of Overload with the Office of Admission for approval or denial of overload situations. By Mail: By Fax: In-Person: Carl Albert State College Poteau Campus, Hemphill Hall Office of Admissions Sallisaw Campus 1507 So McKenna Poteau, OK Questions: Contact Office of Admissions or Sallisaw Campus

3 Concurrent Enrollment Guidelines C A R L A L B E R T S T A T E C O L L E G E Office of Admissions 1507 So McKenna Poteau, OK voice fax ADMISSIONS REQUIREMENTS FOR NEW CONCURRENT STUDENTS TO CARL ALBERT STATE COLLEGE In accordance to the Oklahoma State Regents for Higher Education, a senior or junior high school student who is enrolled in an accredited high school may be admitted to CASC if he/she meets the requirements set forth below: Seniors: 3.0 GPA or 19 ACT score or higher Juniors: 3.5 GPA or 21 ACT score or higher Students receiving instruction at home (Home Schooled) or from an unaccredited high school are considered a senior at age 17 and a junior at age 16 (based upon summer entry term and when high school peer class will graduate). GED recipients remain under concurrent enrollment policy until their high school class has graduated. Admissions requirements and course eligibility apply as stated. DOCUMENTS NEW CONCURRENT STUDENTS MUST SUBMIT 1) Application for Admissions 2) Immunization Compliance Waiver Form 3) NATIONAL ACT Test scores 4) Official high school transcript 5) Permissions Form for First-time Entering Students 6) High School Course Schedule for term of enrollment 7) Copy of Social Security Card and 8) Copy of Driver s License COURSE ELIGIBILITY Concurrent students must obtain a 19 or higher on their ACT subject test score in English 1113, mathematics, and science to enroll into courses in those respective subject areas. A 19 or higher Reading ACT subject test must be scored to enroll in any other collegiate course (outside the subjects of English, mathematics, and science). Concurrent students may not enroll in zero-level courses. Concurrent students may not take a COMPASS exam to remove any deficiency Concurrent students may enroll in 9 semester hours in the summer term without also being enrolled in high school. Students may enroll in a combined number of high school and college courses of 19 semester credit hours. All graded ½ unit high school classes are valued to 3 credit hours. To remain enrolled, the Office of Admissions will confirm that this 19 cr-hr limit is met by examining the high school and college course schedules. Students must submit a course schedule from their high school each semester of concurrent enrollment (summer, fall, spring). If course schedule is not submitted to the Office of Admissions before classes begin, then, the student will be Withdrawn from all CASC classes. Students enrolled in more than a combined 19 credit hours must submit a Petition for Overload to the Office of Admissions and if approved may enroll in or remain enrolled in 19 or more hours. If Petition is not submitted before classes begin, then, student will be Withdrawn from CASC classes. Concurrent students may continue enrollment in subsequent semesters with a cumulative college 2.0 GPA. Students whose GPA falls below 2.00 will be immediately suspended from CASC, ineligible to enroll under concurrent enrollment, and must wait until after their high school graduation to enroll in college. Students may enroll into accelerated courses when their high school is not in session. Students can view their final grades on-line through their VIKECONNECT account. Grades are not postal mailed. With signature on the Permissions Form, students give the Office of Admissions permission to mail an official transcript to the high school and to visit with the high school counselor/school official on their behalf. TUITION WAIVER & FEES SENIORS who are Oklahoma Residents and attending an Oklahoma high school and are eligible for a Tuition Waiver that waives only tuition charges, and for a maximum of 6 hours per semester. Students are responsible for fees, books, and other education expenses. Student accounts balance must be paid to re-enroll. (Billing questions call Poteau or Sallisaw ). PARENTS AND RELEASE OF INFORMATION: FERPA In accordance with the Family Educational Rights and Privacy Act (FERPA) of 1974, CASC must obtain written consent before releasing a student s records to a third party. Parents included. However, the Office of Admissions has male available the Permission to Release Student Records form in their office or online (see Admissions>Student Forms) that gives parent(s) permission to obtain information, transcripts, course schedules, and other documents on their student. RETURNING CONCURRENT STUDENTS Returning students must submit: 1) Permissions Form for Returning Concurrent Enrollment Students, 2) course schedule for term of concurrent enrollment, 3) any National ACT test scores that updates/supports enrollment, and have a minimum 2.00 college GPA and a zero balance with CASC Business Office. (Billing questions call Poteau or Sallisaw ). VIKECONNECT Students must establish their VIKECONNECT account and obtain Username & Password to access BLACKBOARD & Student . > Quick Links > VIKECONNECT > Reset Password

4 Please know that: Permissions Form For First-Time High School Concurrent Enrollment C A R L A L B E R T S T A T E C O L L E G E Office of Admissions 1507 So McKenna Poteau, OK voice fax (see attached Guidelines for more details) 1. Tuition waivers are given to seniors who are Oklahoma residents and attend an Oklahoma high school, and for up to 6 hours per semester. (Student remains liable for fees, books, and hours taken above 6.) 2. Accelerated courses may be taken only when the high school is not in session. 3. With their signature below, students give the Admissions Office permission to mail their official CASC transcript to their high school and visit with school officials concerning their enrollment or progress. 4. Students must submit their high school course schedule before classes begin or will be Administratively Withdrawn from all college classes. Students judged to have over 19 combined cr-hrs will be Administratively Withdrawn or given the opportunity to file a Petition for Overload with the Office of Admissions. Cumulative college GPA : (If less than 2.00, then student is ineligible and may not enroll as HS Concurrent). Student Full Name: Social Security Number: High School: CASC ID#: Semester (check one): Summer Fall Spring Year (write-in): 20 Class (check one): Senior Junior If we have questions, please tell us your and/or cell#: 1) 2) Student Signature: Date: P L E A S E W R I T E - I N T H O S E C O U R S E S Y O U W I S H T O E N R O L L : COURSE NUMBER SECTION # COURSE DESCRIPTION DAY/TIME INSTRUCTOR High School Principal Certification and Permission As high school principal, I have examined the academic record for this student and certify that he/she is eligbile to satisfy high school gradution requirements no later than the last semester of their senior year. Principal Name (please print): Signature: Date: High School Counselor Certification and Permission As high school counselor, I certify that he/she is eligible for concurrent enrollment at CASC and judge them to be academically ready for college-level courses. I certify that this student meets the ACT subject test eligibility requirements to enroll in the above classes. I will work with CASC to verify the student is enrolled in 19 or fewer combined hours or help any eligible student file the Petition for Overload when 19 or more combined hours are requested. Counselor Name (please print): Signature: Date: Parent/Guardian Permission As parent or legal guardian, I give by permission for this student to enroll concurrently with the high school and Carl Albert State College in the courses and semester listed above. Parent/Guardian Name (please print): Signature: Date:

5 ID: Application for Admissions Modified for High School Concurrent Enrollment Students C a r l A l b e r t S t a t e C o l l e g e Office of Admissions 1507 So McKenna Poteau, OK fax voice >CASC PORTAL>Admissions Instructions: This Application is modified for Concurrent Enrollment Students. -- Students must submit the 1) Concurrent Enrollment form, 2) Applications for Admissions, and credentials for full enrollment (high school transcript, ACT test scores, high school COURSE SCHEDULE). Students are asked to print clearly; answer all items listed; read, understand, and sign the signature page. Application and credentials may be submitted in person to the Office of Admissions at the Poteau or Sallisaw campuses, by mail or fax to the address above. Entry Information Campus Poteau Sallisaw Web Term Summer 20 Fall 20 Spring 20 Entry Classification High School Concurrent Are you seeking a degree with CASC? No, I am enrolling as a Concurrent High School or Non- Degree Seeking/Special student Applicant Information Social Security Number - - Birth Date / / Legal Name Last First Middle Suffix What is your Age? Previous Names Address City State Zip County Home Phone Cell Phone Sex Male Female Emergency Contact Full Name Marital Status Single Married Divorced Separated Phone General Information Ethnicity/Race This information is voluntary and is used for state & federal reporting. This information does not affect your admissions to CASC. American Indian/Alaskan Native Not Hispanic/Latino Hispanic/Latino (check all that apply) Tribe: Lineage: Father Mother Both Unknown Asian Black/African American Native Hawaiian/Pacific Islander White Family Education Background Has your Mother earned at least a Bachelor s degree? Yes No Has your Father earned at least a Bachelor s degree? Yes No Are you the first member of your family to attend college? Yes No Office of Admissions 1507 S McKenna Poteau, OK voice fax

6 ID: APPLICATION FOR ADMISSI ONS M O D I F I E D F O R H I G H S C H O O L C O N C U R R E N T E N R O L L M E N T OFFI CE OF ADM IS SIO N S Application for Admissions Modified for High School Concurrent Enrollment Students Residency & Citizenship Are you a US citizen? US Citizen Legal Permanent Resident Undocumented Resident If not, what is your country of citizenship? Are you a resident of Oklahoma? Yes No How long? years months -or- Lifetime If not, list state of residency? How long? years months An Oklahoma Resident is one who has lived continuously in Oklahoma for the last 12 months for reasons other than education and whose domicile is Oklahoma. (Change of residency questions should be directed to the Office of Admissions.) Educational Background Office Use High School Name of High School City/State Anticipated Graduation Home School (mo/year) Have you taken? ACT SAT (National ACT Test only) Have you previously attended any Oklahoma vocational school? Yes No Have you previously attended any other college or university? Yes No (If yes, an official transcript is required from all colleges previously attended and prior to successful admissions and enrollment) Codes List all Colleges previously attended City/State Dates Attended Hours Earned Disclosure Requirement 1. Have you ever been convicted of a felony? Yes No 2. Have you ever been placed on disciplinary probation or suspension from a college or university? Yes No If you answer Yes to either question, please attach a written statement of disclosure (plain sheet of paper, dated, and signed). Signatures Read & Sign READ and SIGN: With my signature below, I avow that all information is complete and accurate. I understand that falsification of this application or my academic records (including failure to list all colleges previously enrolled) may result in my suspension for academic misconduct and lead to my withdrawal from CASC and complete forfeiture of fees, and/or delay my enrollment and financial aid processing with CASC. I agree to abide by the rules & regulations established by CASC, including payment of all tuition, fees, room/board, books, fines, and all other charges incurred at CASC. Student PRINT Name Student Signature Date Parent/Legal Guardian PRINT Name Parent/Legal Guardian Signature Date In compliance with Titles VI and VII of the Civil Rights Acts of 1964, amended, Title IX of the Education Amendments of 1972, American Disabilities Act of 1990, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, disability, or status as a veteran in any of its policies, practices, or procedures. This includes but is not limited to admissions, employment, financial aid, and educational services. Please contact our ADA Coordinator at if you have any questions regarding services for students with disabilities. Office of Admissions 1507 S McKenna Poteau, OK voice fax

7 APPLICATION FOR ADMISSI ONS M O D I F I E D F O R H I G H S C H O O L C O N C U R R E N T E N R O L L M E N T Immunization Compliance Form Immunization Policy: Exemption Statement for Students with Exemptions or Exceptions ID: OFFI CE OF ADM IS SIO N S In Compliance with Oklahoma Statutes, Title Instructions: Students who successfully complete and sign this form do not have to provide the Office of Admissions with Immunization Records. - - State law allows for certain exemptions based upon medical contraindications, religious or moral objections. The Board of Regents, in its discretion, includes exceptions to the requirement for vaccinations for each of the following categories of students. Additionally, the immunization requirement shall not apply to students enrolling in courses delivered through the Internet or at distance learning sites which the student is not required to attend class on campus. Check Exemption below: List High School: concurrently enrolled high school student; graduated from a high school in a state that requires vaccinations for hepatitis B, measles, mumps, and rubella; transferring from an institution within The Oklahoma State System of Higher Education or private institution of higher learning located within this state and accredited pursuant to Section 4103 of Title 70 of the Oklahoma Statutes; born before January 1, 1956; a member of a National Guard Unit or Military Reserve Unit or who is currently on active duty in a branch of the United States military, or enrolling only in web-based courses or at a distance learning site. Religious Objections: (summarize: ) Moral or Personal Objection: (summarize: ) Medical Contraindications (to be completed by Physician: Physician Signature Date Student Signature Required: Additional information on immunizations may be found at: Student PRINT Name Student Signature Date Center for Disease Control Local health departments Office of Admissions 1507 S McKenna Poteau, OK voice fax

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