Dual Credit Online application

Transcription

1 Dual Credit Online application 1. Please go to internet explorer 2. Go to website eastfieldcollege.edu 3. Click on current & future student on right-hand side 4. Click on application on the left-hand side. 5. Then click on link below * If highlighted in yellow those are the questions that you as the student will have to answer only. * If highlighted in blue those are the answers that you as the student will have to choose. LET S BEGIN!

2 A d m i s s i o n s Ap p l i c a t i o n f o r H i g h S c h o o l S t u d e n t s - N e w U s e r / Ac c o u n t C r e a t i o n Already have a username? Login Once your new account has been created, you may complete the application during single or multiple sessions. Once all parts have been completed and submitted, you will no longer be able to re-edit. User Information All fields marked with an asterisk (*) are required. You must use your legal name. Please use upper and lower case as appropriate. It is important that you fill in these fields as you would like them to appear on your application. You will not be able to change this information once your account is created. * First Middle * Last/Family Home Phone: Work Phone: Cell Phone: Ext: - - * Address: * Confirm Address: * Please choose one of the following: I currently live in Texas. I currently live in the United States, but not in Texas. I currently live outside of the United States. * Please indicate on what basis you are seeking admission. Check the box that is most appropriate. Dual Credit/Concurrent Gives qualified high school juniors and seniors an opportunity to earn college credit while completing high school requirements. Early College High School Collegiate Academy Students ONLY select Early College Is a partnership high school program between Independent School Districts and Dallas County Community Colleges that offers high school students, most of whom are first

3 generation college students, the opportunity to earn an Associates Degree by the time they graduate from high school. Middle College High School Provides motivated, mature students a unique opportunity to attend a high school located on the El Centro College campus. Gateway to College A program that allows students to complete their high school diploma and progress towards a college degree or certificate. Students eligible for the Gateway to College program are students who have earned no more than 17 high school credits and/or within five credits from graduation; are current or former Garland or Mesquite ISD students who reside in those school districts; and are between 16 to 20 years old. AVID program A national high school-based program geared toward preparation for college. Create a Username Your username is very important. Your username will remain with you throughout this application process. Use letters and/or numbers only, no spaces or special characters, and a minimum of 5 characters. * Username: Create a Password Enter your password twice. Use letters and numbers only, no spaces or special characters, and a minimum of 6 and a maximum of 9 characters. The password must contain at least 1 alpha character and 1 numeric character. * Password: * Confirm Password: Remember your username and password are not case sensitive. If you have provided your address, you will receive notification of your username and password. Otherwise, please make a note of them for future use. Please review all of the above information for accuracy. You will not be able to change this information once your account is created. Create Account and Continue Create Account and Exit

4 A d m i s s i o n s Ap p l i c a t i o n - P a g e I Page I» Page II» Page III» Page IV» Page V» Review» Submit Currently Being Used Only for Credit Enrollment Educational opportunities are offered by the colleges of the Dallas County Community College District (DCCCD) without regard to race, color, age, religion, gender, national origin, age, disability, sexual orientation, gender identity, gender expression, or any other basis prohibited by law. The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect to their education records. For information see the online catalog FERPA page for more details. All fields with an asterisk (*) are required. First Dual Middle Last Credit College Plans *What semester will you begin taking classes: Spring 2014 * Reason for Attending: * I plan to take courses primarily through: One Year Certificate Two Year Degree Improve Job Skills Transfer to a University Personal Interest Uncertain Brookhaven College Cedar Valley College Dallas Colleges Online (Online classes) Eastfield College El Centro College Mountain View College rth Lake College Richland College Students who apply to one of the colleges listed above, are eligible to attend any of the colleges within the Dallas County Community College District. Part A: Biographical Information * Your Social Security Number or tax identification number is required. Your number will remain confidential. Supplying your Social Security Number enables a more expedient match of your test scores, transcripts and financial aid benefits. The following is my social security number or tax identification number. I do not have a Social Security Number or a tax identification number.

5 * Date of Birth: Month Day Year (YYYY) Current Street Address: (Number, street, apt number only, no PO Box numbers.) * Line 1: Line 2: * City: Other City: If your City is not listed, please select "Other/t listed" and enter it in the "Other City" field. * State: TX * Zip Code: * Please choose a county: DALLAS * How long have you lived at this address? Years: Months: Permanent Mailing address: (If different from Physical street address above, can include PO Box numbers. te: Line 1, City, State, and Zip required if Mailing Address supplied.) Line 1: Line 2: City: State: Zip Code: * Place of Birth: City: State: Country: United States - OR - How do you identify yourself? The following information is collected for statistical and state reporting

6 purposes only. * Ethnicity: Hispanic or Latino origin t Hispanic or Latino origin Unknown or I choose not to respond * Gender: Female Male * Race: (select all that apply) American Indian or Alaskan Native Asian/Pacific Islander Black/African-American International/n-Immigrant Native Hawaiian or other Pacific Islander White Other/I choose not to respond. What is your primary language? Citizenship * 1. Are you a U.S. Citizen? If "", of what country are you a citizen? 2. If you are not a U.S. Citizen, do you hold Permanent Residence status (valid I-551) for the U.S.? If "," date permanent resident card issued: Month Day Year (YYYY) Alien Number: (A copy of your card will be required.) 3. If you are not a U.S. Citizen or permanent resident, do you have an application for permanent residence (form I-485) pending with the U.S. Citizenship and Immigration Services (USCIS)? (If "," a copy of your tice of Action from the USCIS, form I-797C, will be required.) 4. If you are not a citizen or permanent resident or have no application pending with the USCIS, did you live or will you have lived in Texas for 36 consecutive months leading up to high school graduation or completion of the GED? or N/A (If "," please submit a completed "Affidavit of Intent to Become a Permanent Resident.") Military-Veteran Status * If you have any military affiliations, please indicate by selecting all that apply: Current/Former member of the US Armed Forces

7 Current/Former member of the National Guard Current/Former member of the Reserves Dependent of a veteran Dependent of a deceased veteran Dependent of a veteran with a combat-related injury ne of the above Emergency Contact * Name of Person to Contact in Case of an Emergency: * Emergency Contact Telephone Number: - - You have completed 1 of 5 pages. Save and Continue Save and Exit A d m i s s i o n s Ap p l i c a t i o n - P a g e I I Page I» Page II» Page III» Page IV» Page V» Review» Submit Do not use the browser's "Back" button to return to a previous page. Use the "Return to Previous Page" button at the bottom of the form.

8 Currently Being Used Only for Credit Enrollment. All fields marked with an asterisk (*) are required. First Dual Middle Last Credit Part A (Cont.) High School or International Equivalent Education * Which of the following best describes your High School Education? I am or will be a High School Graduate. I am not a High School Graduate, but I have received my GED Equivalency. If selected, which version? And in which state did you receive your GED? I am not a High School Graduate. * What year did you or will you graduate from High School? OR what year did you receive your GED Equivalency? OR what year did you last attend school? (YYYY) * Which best describes your High School or International Equivalent? Texas High School If you graduated or will graduate from a Texas High School, please select it from the list: Select from All Texas High Schools Select a City to narrow the list Optional: (te: Selecting a city may take a few seconds to refresh the School list, please be patient. It will also remove any school you already have selected.) Home School If you graduated or will graduate from Home School, please select it from the list: Select from Home High Schools * Please answer the following: 1. Did you take a Tech Prep course (or courses) for college credit? 2. To determine TEXAS Grant eligibility, will you graduate from a Texas public high school with the Recommended or Distinguished Achievement Program? 3. Did or will you graduate with an IB diploma? Previous College Work * Which of the following best describes you? I have no previous college experience. I have taken classes only through the Dallas County Community College District colleges (including graduates).

9 I am a graduate of a non-u.s. college. I am a graduate of a U.S. college. I previously attended or wish to transfer from another U.S. college. I wish to attend on a temporary basis. I am still enrolled at another U.S. college. I am a current Dual Credit student with a non-dcccd college. I am a current High School Early Admission student with a non-dcccd college. Previous College Attendance (U.S. Colleges Only) Beginning with your last college attended, please list only the codes for U.S. Colleges you have attended. It is not necessary to list any colleges of the DCCCD. Official transcripts for ALL previous college work (except DCCCD colleges) MUST be submitted. Failure to list all institutions will be considered an intentional omission and may result in the denial of future enrollment. 1. Colleges (College names are listed as they would appear on a transcript. If your college is not listed, please enter the name in section 2 below.) Click here to search for college codes. College Code: Year Last Attended: (YYYY) College Code: Year Last Attended: (YYYY) 2. Other U.S. Colleges t Listed Above (Please enter college name as it would appear on a transcript.) College City State Year Last Attended (YYYY) (YYYY) (YYYY) Within the past 12 months, I have been placed on suspension/dismissal by one of the above colleges. Texas Success Initiative (TSI) An institution of higher education shall assess the academic skills of each entering undergraduate student to determine the student's readiness to enroll in Freshman-level academic coursework. Some students may be exempt from meeting the requirement of the TSI; however, students may be required to meet institutional requirements. * Which of the following best applies to you? I have taken the following test(s):

10 ACCUPLACER ASSET COMPASS TASP THEA MAPS I am claiming one or more of the following Exemptions: 1. I claim an exemption from additional assessment because of qualifying ACT, SAT, or TAKS scores. SAT and ACT scores may not be more than 5 years old from the date of testing. TAKS scores may not be more than 3 years old from the date of testing. Please check which test(s) you are claiming for the exemption. SAT Date taken - Month: Year: Minimum score requirement for exemption: Critical Reading 500, Math 500, Composite 1070 ACT Date taken - Month: Year: Minimum score requirement for exemption: English 19, Math 19, Composite 23 TAKS Date taken - Month: Year: Minimum score requirement for exemption: English Language Arts 2200, Essay 3, Math 2200 Students must provide official scores to the college (Scores on high school transcripts are considered official). 2. I claim an exemption because I have graduated with an associate's degree or a baccalaureate degree from an accredited Texas public institution of higher education. Official transcripts must be provided to prove exemptions. 3. I claim an exemption because I am transferring from a regionally accredited private or independent institution of higher education or a regionally accredited out-of-state institution of higher education and have satisfactorily completed college-level coursework in English and Math. 4. I claim an exemption because I am serving on active duty as a member of the U.S. armed forces, the Texas National Guard, or as a member of a reserve component of the U.S. armed forces and have been serving for a least 3 years preceding enrollment. I have not taken any of the tests listed above and I am not claiming an exemption. I understand that I must take a test prior to registration. You have completed 2 of 5 pages. Save and Continue Save and Exit A d m i s s i o n s Ap p l i c a t i o n - P a g e I I I Page I» Page II» Page III» Page IV» Page V» Review» Submit Do not use the browser's "Back" button to return to a previous page. Use the "Return to Previous Page" button at the bottom of the form. Currently Being Used Only for Credit Enrollment All fields marked with an asterisk (*) are required. First Dual Middle Last Credit Texas Higher Education Coordinating Board rule requires each student applying to enroll at an institution to respond to a set of core residency questions for the purpose of determining the student's eligibility for classification as a resident. Part B: Previous Enrollment * 1. During the 12 months prior to the term for which you are applying, did you attend a public college or

11 university in Texas in a fall or spring term? If "", skip to PART C - Residency Claim. If "yes", complete questions 2 thru What Texas public institution did you last attend? 3. In which semesters were you last enrolled? (Check all that apply) Fall 2013 Spring During your last semester at a Texas public institution, did you pay resident (in-state) or nonresident (out-of-state) tuition? Resident (in-state) nresident (out-of-state) Unknown 5. If you paid in-state tuition at your last Texas public institution, was it because you were classified as a Texas resident or because you were a nonresident who received a waiver? Resident nresident with a waiver Unknown te: If you were enrolled at a Texas public institution during a fall or spring semester within the previous 12 months and were classified as a Texas resident, Skip to PART I - Certification of Information you may Part C: Residency Claim * 1. Are you a resident of Texas? If "", of what state or country are you a resident? US State: - OR - Country: te: If "", you may Skip to PART I - Certification of Information Part D: Acquisition of High School Diploma or GED The following questions are required only if you answerd "" to question 1 in Part C: Residency Claim (above) or may be uncertain of your residency status. 1. Did you live or will you have lived in Texas the 36 consecutive leading up to graduation from a public or private Texas high school or completing a GED in Texas? (To answer "yes," you must either graduate from a Texas public or private high school or earn or plan to earn a GED in Texas. All others, including Texas home-school students who do not plan to earn a GED in Texas, must answer "no.") 2. When you begin the semester for which you are applying, will you have lived in Texas for the previous 12 consecutive months? Part E: Basis of Claim to Residency The following questions are only required if you answered "" to question 1 or 2 in Part D: Acquisition of High School Diploma or GED (above) or who did not graduate from a Texas high school. 1. Do you file your own federal income tax as an independent taxpayer? (An independent tax payer should not be claimed as a dependent for tax purposes by another person. If you file a joint return with your spouse, answer yes. ) 2. Are you claimed claimed as a dependent or are you eligible to be claimed as a dependent by a parent or court-appointed legal guardian? (To be eligible to be claimed as a dependent, your parent

12 or legal guardian must provide at least one half of your support. A step-parent does not qualify as a parent if he or she has not adopted you.) 3. If you answered "" to both questions above, who provides the majority of your support? Self Parent or Guardian Other: (list) If you answered "" to question 1 and 2 and "Other" to question 3, please explain: You have completed 3 of 5 pages. Save and Continue Save and Exit A d m i s s i o n s Ap p l i c a t i o n - P a g e I V - Skip page IV and click on Save and Continue Page I» Page II» Page III» Page IV» Page V» Review» Submit Do not use the browser's "Back" button to return to a previous page. Use the "Return to Previous Page" button at the bottom of the form. Currently Being Used Only for Credit Enrollment. All fields marked with an asterisk (*) are required. First Dual Middle Last Credit Part F: Basis of Claim to Residency based on self This section is not required. Any answers entered here will not be submitted with your application. 1. Are you a foreign national who has submitted an application for Permanent Resident Status to the U.S. Citizenship and Immigration Service (USCIS) and has received a fee/filing receipt or tice of Action (I- 797) from USCIS showing that your I-485 has gone through preliminary review and not been rejected? 2. Are you a foreign national here with a visa eligible to domicile in the United States or are you a Refugee, Asylee or Parolee or here under Temporary Protective Status? If so, indicate which? (From Part A)

13 3. a. Do you currently live in Texas? If you are out of state due to a temporary assignment by your employer or other temporary purpose, please answer "no" and explain: b. If you currently live in Texas, how long have you been living here? Years: Months: c. What is your main purpose for being in the state? Attend College Work Assignment Establish and Maintain a Home Other, please explain: d. While living in Texas, have you: (Check all that apply) i. Been gainfully employed for at least a consecutive 12-month period? (Gainful employment requires an average employment of at least 20 hours per week for one year or earnings equal to at least half of tuition and living expenses for one 9-month academic year. Employment conditioned on student status such as work-study, the receipt of stipends, fellowships or research or teaching assistantships does not constitute gainful employment.) ii. Received services from a social service agency for at least a consecutive 12-month period? You have completed 4 of 5 pages. Save and Continue Save and Exit A d m i s s i o n s Ap p l i c a t i o n - P a g e V Page I» Page II» Page III» Page IV» Page V» Review» Submit Do not use the browser's "Back" button to return to a previous page. Use the "Return to Previous Page" button at the bottom of the form. Currently Being Used Only for Credit Enrollment. All fields marked with an asterisk (*) are required. First Dual Middle Last Credit Part H: General Comments Is there any additional information that you believe your college should know in evaluating your eligibility to be classified as a resident? If so, please provide it below (maximum of 1000 characters, including spaces): 1000 characters left Part I: Certification of Information and Meningitis section. All students must complete this section.

14 Bacterial Meningitis Who: Students must provide the college with proof of meningitis vaccination if: You are enrolling for the first time as a credit student. You are returning after a semester break in enrollment. You are transferring from another college or university. You are a new or returning continuing education student enrolled in programs with 360 contact hours or more. You are a dual credit, Middle College, Early College or charter high school student attending classes on the college campus. You are a continuing education student who is enrolled in concurrent credit courses. Deadline: You must submit proof of vaccination (or booster shot within the last five years) to your college's Admissions/Registrar's Office before registering for class. The date of the vaccination must be at least 10 days before the first day of class before the first day of the first semester in which the student initially enrolls at the college. Where: Take proof of bacterial meningitis vaccination to the Admissions/Registrar's Office on the campus where you are enrolled. Exceptions: A student is not required to submit evidence of receiving the vaccination against bacterial meningitis or evidence of receiving a booster dose if: You are 22 years of age or older (by the first day of the semester in which you are enrolled). You are enrolled 100% in distance education classes. You must complete the 100% Distance Education Affidavit and fax or it to your college. Find it at You are enrolled in a continuing education course or program that is less than 360 contact hours or in continuing education corporate training. You are enrolled in one or more dual credit courses taught at a public or private K-12 facility which is not located on a college campus. You are incarcerated in a Texas prison. Exemptions: A student, or a parent or guardian of a student, is not required to submit evidence of receiving the vaccination against bacterial meningitis if the student, or a parent or guardian of a student, submits to the Admissions/Registrar's Office one of the following: An affidavit or certificate signed by a physician who is duly registered and licensed to practice medicine in the United States in which it is stated, in the doctor's opinion, that the vaccination would injure the health and well-being of the student; OR An affidavit signed by the student stating that the student declines the vaccination for reasons of conscience, including a religious belief. A conscientious exemption form from the Texas Higher Education Coordinating Board at for students who are 18 years of age or older, or the Texas Department of State Health Services (DSHS) for students who are 17 years of age or younger must be used. Students may obtain bacterial meningitis vaccinations from their own physicians, local health departments, clinics, area drug stores and similar facilities. For more information about bacterial meningitis, visit the Centers for Disease Control at I understand that officials of my college will use the information submitted on this form to determine my status for residency eligibility. I authorize the college/university to verify the information I have provided and obtain my Texas Success Initiative (TSI) test scores as necessary. I agree to notify the proper officials of the institution of any changes in the information provided. I certify that the information in this application is complete and correct and I understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment, or appropriate disciplinary action. I understand that, by enrolling, I have received or will receive information about bacterial meningitis from the college as required by Section of the Texas Education Code. * By checking this box, I am attaching my electronic signature verifying that I will comply with the Residency Oath above. I will submit all official transcripts from all U.S. accredited institutions previously attended. The Admissions/Registrars Office reserves the right to request additional information in order to comply with state residency requirements prior to enrollment. Students found to have been incorrectly classified as a resident for tuition purposes due to information/documentation submitted must begin to pay the nonresident rate immediatly and have a maximum of 30 days to repay all previous terms. DOCUMENTS SUBMITTED TO MEET ADMISSIONS AND RESIDENCY REQUIREMENTS BECOME

15 THE PROPERTY OF THE COLLEGE. The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect to their education records. The information collected about you is not disclosed to any non-affiliated entity, except as permitted by law. For information see the online catalog FERPA page for more details. If you wish to protect your directory information from disclosure, proceed to the following website or contact the Admissions/Registrars Office. For information see: You have completed all five pages of the admission application. You are now ready to review your application prior to submission. Save and Continue Save and Exit A d m i s s i o n s Ap p l i c a t i o n - R e v i e w Ap p l i c a t i o n Page I» Page II» Page III» Page IV» Page V» Review» Submit Do not use the browser's "Back" button to return to a previous page. Use the "Return to Previous Page" button at the bottom of the form. Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion, sex, disability or sexual orientation. The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect to their education records. For information see the online catalog FERPA page for more details. First Dual Middle Last Credit Please review the following information. If anything needs to be corrected, click on the button for that section's information to return to that page to make corrections. For example, to change your mailing address in "Part A" you would click the "Make Corrections or Additions to Page I" button.

16 College Plans * What semester will you begin taking classes: Fall 2014 * Reason for Attending: Two Year Degree * I plan to take courses primarily through: Eastfield College You have completed the review of your DCCCD Admissions Application. Save and Continue Exit Without Saving Ad m i s s i o n s Ap p l i c a t i o n : Su b m i t Ap p l i c a t i o n Almost finished... Please Continue the process by clicking the "Submit My Application" button below. Please do not use the back button once you submit your application. Processing may take up to 3 minutes. Thank you. Submit My Application Application for Admission Results Letter of Acceptance Congratulations! You have been accepted to Eastfield College, one of the colleges of the Dallas County Community College District (DCCCD). The information you have provided is: Dual Credit SSN: Address: 3737 Motley Drive Mesquite, TX Work Phone: Home Phone: Ext:

17 Currently reside: Cell Phone: In Texas Birthdate: 02/08/1995 We encourage you to review "Your Admission Status" and the "Next Steps" below. Additional information and/or documentation may be required in order to pay a lower tuition rate, register in college level courses, or be eligible to register online through our econnect. (econnect is a college web service that lets you get personalized information and handle other tasks online.) Your admission Status Based on the information you provided, your admission status is Admitted, High School Graduate. Your Admission Status: Admitted, High School Graduate You intend to begin classes: Fall 2014 Your residency for tuition purposes: In County Residence The personal student identification number that has been assigned to you is: This is your DCCCD ID# It is important to secure this number. You will use this number to activate your econnect account and for on-campus services. Also, if you are new to college or will need to be assessed for College Readiness, you must complete a pre-assessment activity which can be found at Please see "Next Steps" below for further instructions.