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High School Dual Credit Program South Dakota Board of Regents Black Hills State University Dakota State University Northern State University South Dakota School of Mines & Technology South Dakota State University University of South Dakota Thank you for your interest in the High School Dual Credit Program through the South Dakota Board of Regents (SD BOR) in partnership with the SD Department of Education. Each of the six South Dakota Public Institutions of Higher Education offer a variety of courses meeting the SD BOR system general education requirements. High school juniors and seniors attending a public high school within South Dakota may be eligible to participate in this program and receive both high school and college credit at a reduced rate of $40.00 per credit. A new application must be submitted for each semester in which you wish to participate. Admission requirements: A high school junior or senior attending a public high school within SD Meet undergraduate admissions requirements (ACT or coursework); or If high school senior, rank in upper one-half of their class or score at or above 50th percentile on a nationally standardized, norm-referenced test, such as the ACT or SAT; or If high school junior, rank in upper one-third of their class or score at or above 70th percentile on a nationally standardized, norm-referenced test, such as the ACT or SAT The following items must be submitted: High School Dual Credit Program Application (p. 2 & 3) High School Transcript ACT/SAT Score Report (if taken)* *Registration in select courses will require placement via ACT/SAT and/or Accuplacer. If you have questions, please contact the appropriate campus/center point of contact: POINTS OF CONTACT FOR HIGH SCHOOL DUAL CREDIT PROGRAM Campus Name Title Email Phone BHSU Mitch Hopewell Interim Director of Educational Outreach Thomas.Hopewell@bhsu.edu 605-642-1241 CUC Laura Hayden-Moreland Academic Program Coordinator Laura.HaydenMoreland@sdstate.edu 605-773-3024 DSU Peg O'Brien Director of Extended Programs Peg.Obrien@dsu.edu 605-256-5048 NSU Ronald Brownie Director of Online & Continuing Education Ronald.Brownie@northern.edu 605-626-2568 SDSM&T Molly Frankl Director of Admissions Molly.Frankl@sdsmt.edu 605-394-2649 SDSU Carey Kilmer Assistant Director-Continuing & Distance Education Carey.Kilmer@sdstate.edu 605-688-4959 USD Gary Girard Director of Programming Gary.Girard@usd.edu 605-677-6112 RCUC Maria Hartung Coordinator of Admissions and Marketing Maria.Hartung@bhsu.edu 605-718-4194 SFUC Sarah Rasmussen Assistant Director, Academic and Student Services sarah.rasmussen@sduniversitycenter.org 605-367-5381 1

High School Dual Credit Program South Dakota Board of Regents Black Hills State University Dakota State University Northern State University South Dakota School of Mines & Technology South Dakota State University University of South Dakota Legal Name Preferred First Name Last First Middle Social Security Number Birth Date XXX-XX-XXXX Use of Social Security Number (SSN) - Privacy Information: We are requesting your SSN for administrative record accuracy and reporting. Disclosure of your SSN is voluntary and if you decline to provide it to us this action will not affect your admissions eligibility. However, we request this information from you in order to meet our federal obligation to report student employment, Hope and Lifetime Scholarship tax information, and federal financial aid. The SSN is confidential information under the Federal Educational Rights to Privacy Act and we will not release it without your consent. Having your SSN on record will enable the University to keep accurate information and to report it promptly. Permanent Mailing Address Street City State Zip Code Telephone (555-555-5555) Emergency Contact Name E-mail Address Relationship to you Street City State Zip Code Telephone (555-555-5555) Educational Data High School Attending School City State Status: Junior Senior Other: Have you taken the ACT test? Yes No Date Tested (MM/YY): Composite Score: ACT Subscores: English Mathematics Reading Science Have you taken the SAT test? Yes No Date Tested (MM/YY): Composite Score: Were your scores sent to a SD BOR Institution? Yes No Course Information University you are applying to: BHSU DSU NSU SDSM&T SDSU USD Semester you wish to enroll: Fall 20 Spring 20 Summer 20 Have you previously enrolled in courses through any of the SDBOR Universities? Yes No If yes, when (Term/Year) Have you previously enrolled in courses through any other post-secondary institutions? Yes No If yes, where? Location of class(es) you are registering for (Select all that apply.): 5 Digit Course Number On-campus Online University Center (Select Location Below) Pierre Sioux Falls Rapid City Department Prefix Course Number Section Course Title Credit Hours 2

The following information is optional. The information is used in compliance with the Title VI of the Civil Rights Act of 1964. Your responses in no way affect your admission. Gender Male Female Choose One Non-Hispanic or Non-Latino Hispanic or Latino American Indian or Alaskan Native Asian Black or African American Choose as many as apply Native Hawaiian or Other Pacific Islander White Expectations & Guidelines for Dual Credit Enrollment: 1. Courses offered are college courses with college-level expectations and standards. Students will be graded accordingly. 2. All courses will become part of and remain on the student s permanent record. Students will need to disclose in college applications that they have taken college/dual credit coursework. It is the responsibility of the student to contact his/her prospective post-secondary institution and to provide necessary information so the institution may determine if the dual enrollment credits that have been earned are transferable. While all credits earned will be recognized by Regental universities, the institutions cannot guarantee transferability of credits outside of the system. 3. Students will have access to university services such as library, e-mail, and WebAdvisor. Students do not pay student fees and will not be given access to wellness centers, sporting events, or other student activities. 4. Students must be aware of the published add/drop with refund and withdraw dates. 5. Before dropping a dual credit course, students must consult with their high school counselor to determine the best plan to be followed. Once this step has been completed, the student must contact the university offering the course to complete the drop process. Students who stop attending class without processing an official withdrawal will stay on the course roll and be assigned an F for the course. 6. Students will be held accountable for academic dishonesty, plagiarism, and/or cheating as outlined by the University s Student Code. 7. Students must act on their own behalf. Parents, high school officials and others are not permitted to enroll, drop, or add classes on behalf of the student. 8. Students are responsible for tuition/fees and materials associated with dual credit courses. I acknowledge that federal law permits institutions of higher education to disclose academic, enrollment, and financial aid information about me to staff who need to know such information to carry out their administrative tasks. I understand and acknowledge that the institutions that comprise the South Dakota system of higher education are also permitted to share such academic, enrollment and financial aid information, either within or outside the South Dakota system of higher education, when I transfer between institutions or when I enroll in coursework from more than one institution during a term. By participating in this dual credit program, I will be deemed to have consented to the disclosure of academic information, including, but not limited to, academic standing, progress, and grades, both within the system and to my high school. With my signature below I verify that all information on this application is complete and accurate to the best of my knowledge. If admitted, I agree to observe the rules and regulations of the South Dakota Board of Regents system and the respective Universities. Student Signature Date Parent/Guardian Signature Date School Official Signature Signature Date 3

High School Dual Credit Program South Dakota Board of Regents Black Hills State University Dakota State University Northern State University South Dakota School of Mines & Technology South Dakota State University University of South Dakota Confidentiality of Student Records The South Dakota Board of Regents and Universities take the protection of the student and their records seriously. To this end, the Regents have established a policy that requires all institutions to observe the federal regulations as specified in the Family Education Rights and Privacy Act as amended. Further, each institution is required to adopt and to publish annually procedures that enact this requirement. The procedures for each Regental institution can be found at the following links: Black Hills State University: http://www.bhsu.edu/academics/registrationrecords/studentprivacyferpa/tabid/9784/default.aspx Dakota State University: http://www.dsu.edu/academics/online-advising/ferpa.aspx Northern State University: http://www.northern.edu/academics/pages/registrar/privacy.aspx South Dakota School of Mines & Technology: http://www.sdsmt.edu/campus-life/student-resources/policies-and-procedures/ferpa/ South Dakota State University: https://www.sdstate.edu/campus/records/ferpa.cfm The University of South Dakota: http://www.usd.edu/registrar/student-records-policy.cfm 4

Black Hills State University Contact: Mitch Hopewell Phone: 605.642.1241 Email: thomas.hopewell@bhsu.edu Website: http://doe.sd.gov/octe/documents/sdborregf.pdf.pdf Course Number Course Name Location Semester AIS-257-B601 Early Amer Ind Hist & Culture Internet/On-Line Fall 2014 ARTH-100-B601 Art Appreciation Internet/On-Line Fall 2014 ARTH-100-B603 Art Appreciation Internet/On-Line Fall 2014 ARTH-100-B605 Art Appreciation Internet/On-Line Fall 2014 ARTH-212-B601 History of World Art II Internet/On-Line Fall 2014 ECON-201-B601 Principles of Microeconomics Internet/On-Line Fall 2014 ECON-201-B611 Principles of Microeconomics Internet/On-Line Fall 2014 ECON-202-B601 Principles of Macroeconomics Internet/On-Line Fall 2014 ECON-202-B611 Principles of Macroeconomics Internet/On-Line Fall 2014 ENGL-101-B601 Composition I Internet/On-Line Fall 2014 ENGL-201-B601 Composition II Internet/On-Line Fall 2014 ENGL-201-B603 Composition II Internet/On-Line Fall 2014 ENGL-210-B601 Introduction to Literature Internet/On-Line Fall 2014 GEOG-101-B601 Introduction to Geography Internet/On-Line Fall 2014 GEOG-210-B601 World Regional Geography Internet/On-Line Fall 2014 HIST-121-B601 Western Civilization I Internet/On-Line Fall 2014 HIST-151-B601 United States History I Internet/On-Line Fall 2014 HIST-152-B601 United States History II Internet/On-Line Fall 2014 HUM-100-B601 Introduction to Humanities Internet/On-Line Fall 2014 HUM-100-B603 Introduction to Humanities Internet/On-Line Fall 2014 MATH-102-B601 College Algebra Internet/On-Line Fall 2014 MATH-102-B603 College Algebra Internet/On-Line Fall 2014 MATH-103-B601 Quantitative Literacy Internet/On-Line Fall 2014 MATH-281-B601 Introduction to Statistics Internet/On-Line Fall 2014 MATH-281-B603 Introduction to Statistics Internet/On-Line Fall 2014 MCOM-151-B601 Intro to Mass Communication Internet/On-Line Fall 2014 MUS-100-B601 Music Appreciation Internet/On-Line Fall 2014 POLS-100-B601 American Government Internet/On-Line Fall 2014 PSYC-101-B601 General Psychology Internet/On-Line Fall 2014 SOC-100-B601 Introduction to Sociology Internet/On-Line Fall 2014 SOC-100-B603 Introduction to Sociology Internet/On-Line Fall 2014 SOC-150-B601 Social Problems Internet/On-Line Fall 2014 SPAN-101-B601 Introductory Spanish I Internet/On-Line Fall 2014

Dakota State University Contact: Peg O'Brien Phone: 605.256.5048 Email: peg.obrien@dsu.edu Registration Form: http://doe.sd.gov/octe/documents/sdborregf.pdf Course Number Course Name Location Semester BIOL-101-D30 (06061) Biology Survey I Internet/On-LIne Fall 2014 BIOL-101L-D30 (06066) Biology Survey I Lab Internet/On-LIne Fall 2014 ENGL-101-D31 (06294) Composition I Internet/On-LIne Fall 2014 MATH-102-D30 (06533) College Algebra Internet/On-LIne Fall 2014 POLS-100-D30 (06620) American Government Internet/On-LIne Fall 2014 SPCM-101-D30 (06675) Fundamentals of Speech Internet/On-LIne Fall 2014 Northern State University Contact: Ronald Brownie Phone: 605.626.2568 Email: ronald.brownie@northern.edu Registration Form: http://doe.sd.gov/octe/documents/sdborregf.pdf Course Number Course Name Location Semester ARTH 100 N800T Art Appreciation Internet/Online Fall 2014 ARTH 100 N801T Art Appreciation Internet/Online Fall 2014 BIOL 201 N800T Biology Survey I Internet/Online Fall 2014 BIOL 201L N800T Biology Survey I Lab Internet/Online Fall 2014 ECON 201 N800T Principles of Microeconomics Internet/Online Fall 2014 ENGL 101 N800T Composition I Internet/Online Fall 2014 ENGL 201 N800T Composition II Internet/Online Fall 2014 FREN 101 N800T Introductory French Internet/Online Fall 2014 GER 101 N800T Introductory German Internet/Online Fall 2014 MATH 101 N800T Intermediate Algebra Internet/Online Fall 2014 MUS 100 N800T Music Appreciation Internet/Online Fall 2014 MUS 100 N801T Music Appreciation Internet/Online Fall 2014 MUS 100 N802T Music Appreciation Internet/Online Fall 2014 SOC 100 N800T Introduction to Sociology Internet/Online Fall 2014 SPAN 101 N800T Introductory Spanish I Internet/Online Fall 2014 SPAN 101 N801T Introductory Spanish I Internet/Online Fall 2014 SPAN 102 N800T Introductory Spanish II Internet/Online Fall 2014 SPCM 101 N800T Fundamentals of Speech Internet/Online Fall 2014 THEA 100 N800T Introduction to Theatre Internet/Online Fall 2014 THEA 100 N801T Introduction to Theatre Internet/Online Fall 2014

University of South Dakota Contact: Gary Girard Phone: 605-677-6112 Email: gary.girard@usd.edu Registration Form: http://doe.sd.gov/octe/documents/sdborregf.pdf Course Number Course Name Location Semester ARTH 100 Section (U820T) Art Appreciation Internet/On-LIne Fall 2014 ARTH 100 Section (U821T) Art Appreciation Internet/On-LIne Fall 2014 ARTH 212 Section (U820T) History of World Art II Internet/On-LIne Fall 2014 ARTH 251 Section (U820T) American Indian Art History Internet/On-LIne Fall 2014 CHEM-106/L Section (U820T) Chemistry Survey Internet/On-LIne Fall 2014 CHEM-107/L Section (U820T) Chemistry Survey Internet/On-LIne Fall 2014 CJUS 201 Section (U820T) Introduction to Criminal Justice Internet/On-LIne Fall 2014 ECON-201 Section (U820T) Principles of Microeconomics Internet/On-LIne Fall 2014 ENGL-101 Section (U820T) Composition I Internet/On-LIne Fall 2014 ENGL-201 Section (U820T) Composition II Internet/On-LIne Fall 2014 ENGL-210 Section (U820T) Introduction to Literature Internet/On-LIne Fall 2014 ESCI 103 Section (U820T) Earth & Life Through Internet/On-LIne Fall 2014 ESCI 103L Section (U820T) Earth & Life Through Lab Internet/On-LIne Fall 2014 ESCI-101 Section (U820T) Dynamic Earth Internet/On-LIne Fall 2014 ESCI-101L Section (U820T) Dynamic Earth Lab Internet/On-LIne Fall 2014 GEOG-210 Section (U015) World Regional Geography Internet/On-LIne Fall 2014 GFA 101 Section (U820T) Introduction to Fine Arts Internet/On-LIne Fall 2014 HIST-152 Section (U820T) United States History II Internet/On-LIne Fall 2014 HIST-152 Section (U821T) United States History II Internet/On-LIne Fall 2014 INED-211 Section (U820T) South Dakota American Indian Culture Internet/On-LIne Fall 2014 MATH-102 Section (U820T) College Algebra Internet/On-LIne Fall 2014 MATH-103/L Section (U820T) Quantitative Literacy Internet/On-LIne Fall 2014 MATH-121 Section (U820T) Survey of Calculus Internet/On-LIne Fall 2014 MCOM-151 Section (U820T) Introduction to Mass Communication Internet/On-LIne Fall 2014 MUS-100 Section (U820T) Music Appreciation Internet/On-LIne Fall 2014 MUS-100 Section (U821T) Music Appreciation Internet/On-LIne Fall 2014 PHGY-220/L Section (U820T) Human Physiology and Integrated Internet/On-LIne Fall 2014 PHGY-230/L Section (U820T) Human Physiology and Integrated Internet/On-LIne Fall 2014 PHIL-220 Section (U820T) Introduction to Ethics Internet/On-LIne Fall 2014 POLS-100 Section (U820T) American Government Internet/On-LIne Fall 2014 POLS-141 Section (U820T) Governments of the World Internet/On-LIne Fall 2014 POLS-210 Section (U820T) State & Local Government Internet/On-LIne Fall 2014 PSYC-101 Section (U820T) General Psychology Internet/On-LIne Fall 2014 PSYC-101 Section (U821T) General Psychology Internet/On-LIne Fall 2014 SOC-100 Section (U820T) Introduction to Sociology Internet/On-LIne Fall 2014 SOC-100 Section (U821T) Introduction to Sociology Internet/On-LIne Fall 2014 SOC-150 Section (U820T) Social Problems Internet/On-LIne Fall 2014 SPCM-101 Section (U820T) Fundamentals of Speech Internet/On-LIne Fall 2014 STAT-281 Section (U820T) Intro to Statistics Internet/On-LIne Fall 2014 THEA-100 Section (U820T) Introduction to Theatre Internet/On-LIne Fall 2014 THEA-201 Section (U820T) Film Appreciation Internet/On-LIne Fall 2014 THEA-201 Section (U821T) Film Appreciation Internet/On-LIne Fall 2014

South Dakota State University Contact: Carey Kilmer Phone: 605-688-4959 Email: carey.kilmer@sdstate.edu Registration Form: http://doe.sd.gov/octe/documents/sdborregf.pdf Course Number Course Name Location Semester ARTH-100-S03D Art Appreciation Internet/On-line Fall 2014 ARTH-100-S04D Art Appreciation Internet/On-line Fall 2014 ARTH-100-S05D Art Appreciation Internet/On-line Fall 2014 ARTH-212-S01D History of World Art II Internet/On-line Fall 2014 BIOL-101L-S19D Biology Survey I Lab Internet/On-line Fall 2014 BIOL-101L-S20D Biology Survey I Lab Internet/On-line Fall 2014 BIOL-101-S03D Biology Survey I Internet/On-line Fall 2014 BIOL-103L-S01D Biology Survey II Lab Internet/On-line Fall 2014 BIOL-103L-S02D Biology Survey II Lab Internet/On-line Fall 2014 BIOL-103-S01D Biology Survey II Internet/On-line Fall 2014 CHEM-106L-S21D Chemistry Survey Lab Internet/On-line Fall 2014 CHEM-106-S03D Chemistry Survey Internet/On-line Fall 2014 CJUS-201-S02D Intro to Criminal Justice Internet/On-line Fall 2014 ENGL-101-S44D Composition I Internet/On-line Fall 2014 ENGL-201-S28D Composition II Internet/On-line Fall 2014 ENGL-201-S29D Composition II Internet/On-line Fall 2014 ENGL-201-S30D Composition II Internet/On-line Fall 2014 ENGL-210-S02D Introduction to Literature Internet/On-line Fall 2014 ENGL-240-S01D Juvenile Literature Internet/On-line Fall 2014 ENGL-240-S02D Juvenile Literature Internet/On-line Fall 2014 ENGL-240-S03D Juvenile Literature Internet/On-line Fall 2014 ENGL-240-S04D Juvenile Literature Internet/On-line Fall 2014 GEOG-101-S01D Introduction to Geography Internet/On-line Fall 2014 GEOG-131L-S16D Phys Geog Weather/Climate Lab Internet/On-line Fall 2014 GEOG-131-S04D Phys Geography Weather/Climate Internet/On-line Fall 2014 GEOG-132L-S08D Phys Geog Nat Landscapes Lab Internet/On-line Fall 2014 GEOG-132-S03D Phys Geog Natural Landscapes Internet/On-line Fall 2014 GEOG-200-S03D Intro to Human Geography Internet/On-line Fall 2014 GEOG-212-S01D Geography of North America Internet/On-line Fall 2014 HDFS-141-S01D Individual and the Family Internet/On-line Fall 2014 HDFS-141-S02D Individual and the Family Internet/On-line Fall 2014 HDFS-210-S02D Lifespan Development Internet/On-line Fall 2014 HDFS-210-S03D Lifespan Development Internet/On-line Fall 2014 HDFS-210-S04D Lifespan Development Internet/On-line Fall 2014 HIST-112-S03D World Civilizations II Internet/On-line Fall 2014 PHIL-100-S04D Introduction to Philosophy Internet/On-line Fall 2014 PHIL-220-S04D Introduction to Ethics Internet/On-line Fall 2014 PSYC-101-S06D General Psychology Internet/On-line Fall 2014 PSYC-101-S07D General Psychology Internet/On-line Fall 2014 REL-213-S03D Introduction to Religion Internet/On-line Fall 2014 REL-225-S01D New Testament Internet/On-line Fall 2014 REL-250-S03D World Religions Internet/On-line Fall 2014

South Dakota State University (Continued) SOC-100-S04D Introduction to Sociology Internet/On-line Fall 2014 SOC-100-S05D Introduction to Sociology Internet/On-line Fall 2014 SOC-150-S04D Social Problems Internet/On-line Fall 2014 SPCM-101-S34D Fundamentals of Speech Internet/On-line Fall 2014 SPCM-101-S35D Fundamentals of Speech Internet/On-line Fall 2014 SPCM-101-S36D Fundamentals of Speech Internet/On-line Fall 2014 STAT-281-S10D Intro to Statistics Internet/On-line Fall 2014 THEA-100-S03D Introduction to Theatre Internet/On-line Fall 2014 THEA-100-S04D Introduction to Theatre Internet/On-line Fall 2014 WMST-101-S01D Intro Women's Studies Internet/On-line Fall 2014