UVEY F CLD CLD PG ffice of dmissions & ecords www.uccs.edu Counselor/tudent Checklist Post econdary ption / High chool Concurrent pplicant Procedures UDE: 1. Complete the application for admission as an unclassified student. (he application fee is automatically waived for you.) he Parent nformation column of the uition Classification section of the application must be completed with your parents information. 2. ead and sign the pplication ignature section of the High chool Concurrent-upplemental pplication. 3. eceive your notice of admission to the University through the U mail. 4. Before you register: a. f the District is paying your tuition (in advance), submit the uthorization for the Univestiy to bill the District to: he Bursar s ffice, ttn. 3 rd Party Billing, 1420 ustin Bluffs Pkwy Colorado prings, C 80918. his is in lieu of your tuition payment. -orb. f you are paying your own tuition, submit your payment to the Bursar s ffice. For billing questions, please phone 719-255-3396. Either your tuition payment or the authorization for the University to bill the District must be submitted to the Bursar s ffice by the deadline, or your courses will be dropped. 5. Contact the tudent uccess ffice at 719-255-3260 in order to arrange to attend one of the many orientation sessions for new freshmen. 6. egister for classes using your student portal located at www.uccs.edu. PE: 1. ead and sign the parent block of the High chool Concurrent-upplemental pplication. 2. he Parent nformation column of the uition Classification section of the application must be completed with your information. CUEL: 1. ead/review the pplication Checklist and Principal/Counselor ignature block; verify that the application is a likely candidate for admission. 2. ign the Principal/Counselor block of the High chool Concurrent- upplemental pplication (if the student meets the minimum qualifications). 3. Mail an official high school transcript, the supplemental application, and the application for admission to the UCC ffice of dmissions and ecords. 4. Explain your District s payment policy and procedures to the student. (i.e. tuition payment vs. fees and books, and CF reimbursement guidelines.) Provide the student with the written authorization for the University to bill the chool District for the applicable tuition charges, only if your district is paying the tuition. MP FM EGDG CF (College pportunity Fund): High school concurrent and PE students, who are residents of Colorado for tuition purposes, are eligible for CF. onresidents are not eligible for CF but are eligible for reduced tuition equal to the total cost of tuition at in-state rates (excluding CF) F FUHE CE, PLEE CC: UCC dmissions ffice 719-255-3383 1420 ustin Bluffs Pkwy Colorado prings, C 80918
elect the semester and indicate year of expected enrollment HGH CHL CCUE PPLC F DM UCC 1420 ustin Bluffs Parkway, Colorado prings, C 80918, www.uccs.edu, (719) 255 3383 High chool Concurrent - pplciation Fee required Fall pring Year YPE LL FM: nswer all questions completely. ttach additional sheets if necessary. Full legal name: (Do not use nickname) _ First Middle Last ther names which may appear on your academic records. (Please do not use nicknames) P E L F M ocial ecurity o. Birthdate Mailing ddress: Present ge Male Female ther Home/Cell Phone Work Phone o & treet or P.. Box o & treet or P.. Box City tate Zip Code City tate Zip Code ation of Citizenship f not a U.. citizen, what type of visa do you have? f you are a permanent resident (immigrant), please attach a photocopy of your alien registration card. he following elective ervice question must be answered to comply with Colorado tate law: f you are a male between the ages of 17 years and 9 months and 26 years, are you registered with the elective ervice? Yes o nformation on race/ethnicity will be used in the admission process only for statistical analysis. Providing this information is voluntary. re you Hispanic, Chicano, Mexican, Latino, Cuban, Puerto ican, outh or Central merican, or panish origin? Email ddress: Permanent ddress (if different from mailing): Please attach photocopy Yes o elect one or more: merican ndian/laskan ative Black or frican-merican ative Hawaiian or other Pacific slander sian White f you checked merican ndian or laskan ative: re you an enrolled member of a federally or state recognized tribe, with tribal affiliation documentation? Yes o E D U C L F M Emergency Contact nformation: Last ame First ame elationship to applicant Phone ddress umber & treet City tate Zip Code List the high school you earned/will earn your diploma from and all colleges attended. Failure to provide complete information may result in delay in admission, loss of transfer credit, and/or dismissal. nclude correspondence and extension courses. High chool: ame City tate Zip Code Highest grade completed Date of High chool graduation / f not a high school graduate, have you earned a state GED certificate? Yes o f "Yes," photocopy must be attached List LL colleges and universities you have attended or earned credit from, including University of Colorado campuses. ttach additional sheets if necessary. *LL PPLC MU EQUE FFCL CP BE E UCC FM EVEY CLLEGE UVEY HEY HVE EVE EDED EED CED FM.* ame of nstitutions (first to last) City, tate, Zip Dates of ttendance Credit Hours Completed Degree Earned
U re you claiming Colorado residency and in-state tuition classification? Yes o CMPLEE H EC F YU E CLMG CLD -E U CLFC Failure to complete each question fully will result in your being classified as a nonresident. he information you provide will be kept confidential and is used solely to determine residency. Dates of continuous physical presence in Colorado (mo/yr) Date Colorado Driver's License was originally issued (mo/yr) Your Parent / C L F C List exact years of Colorado Motor Vehicle registration (mo/yr) Date of Colorado Voter egistration (mo/yr) / Dates of employment in Colorado (mo/yr) Exact years for which resident Colorado income taxes were filed to Dates of military service, if applicable (mo/yr) Dates of extended absences from Colorado (2 months or more in duration) (mo/yr) eason for absence _ f your parents are separated or divorced, which one lives in Colorado? MP: LL PPLC MU WE HE QUE BELW D G HE PPLC 1. Do you have a pending criminal charge have ever been convicted of a Yes o crime, made a plea of guilty, accepted a deferred judgment, been adjudicated, or been required to register as a sex offender? (Misdemeanor traffic offenses are exempt) G U E 2. Have you ever been placed on probation, suspended, expelled, or been subject to official disciplinary action from any high school or postsecondary institution for any academic misconduct or behavioral misconduct? f you answered "Yes" to either of the above questions, please attach a statement of explanation. hereby certify that to the best of my knowledge the information furnished in this application is true and complete. understand that if found to be otherwise, it is sufficient cause for rejection or dismissal. understand that if admitted as an unclassified student a maximum of 12 hours may be applied to an undergraduate degree or 9 hours MY be applied to a graduate degree. By typing my name below, understand it constitutes a legally binding signature pursuant to the Uniform Electronic ransmissions ct (EU), section 2. Yes o 2. pplicant's ignature Date HGH CHL FFCL: Please fill in (Freshmen applicants only who are currently enrolled in high school) GP (4.0 scale) ank in Class / For how many semesters? check here By Policy of this high school, students are never ranked in class. ignature of high school official: itle:
UVEY F CLD CLD PG HGH CHL CCUE upplemental pplication pplication Checklist Please use this checklist to ensure the completeness and accuracy of your application. Complete the UCC High chool Concurrent pplication. o application fee is required. nclude a sealed, official high school transcript, including rank in class. nclude C,, or P test results if available. Complete this supplemental application, including all signatures. E: High school concurrent admission is for E term only. You must submit a new upplemental pplication for each term you wish to attend. Principal/Counselor ignature have reviewed the education plans of and the admission requirements, listed below. recommend admission on a concurrent basis for the term of 20. dmissions equirements (must meet all three): op 10%-20% high school rank-in-class. Completion of 4.5 or more academic units each year of high school. C composite of 25 or combined score of 1120 or P combined score of 1410 if available. Date: ignature: Parent ignature understand that college credit earned by a high school student will count in the University record and that all academic/conduct rules of the University will apply to my child. Date: ignature: pplicant ignature Please list your proposed subject areas of study: understand that all grades earned while enrolled as a concurrent student will form part of my overall college GP and that must report my attendance at the University to any subsequent college or university which attend. Date: ignature: oc. ec. #: dmissions Committee ction ction: Date: ignature:
EWDE GEEME BEWEE CLD CHL DC and a CLD CLLEGE HGH CHL CCUE ELLME You have indicated that you are interested in enrolling in a college course while a high school student. he tate of Colorado provides several options for high school students who meet high school standards to begin college early. he purpose of these options include promoting content standards, providing academic challenges, and providing access to academic courses that may not be available at a local high school to meet high school graduation requirements. ll Colorado public four-year and two-year colleges, four area vocational schools, and the three private colleges participate in the following high school concurrent enrollment programs. High school seniors who have completed their high school graduation requirements may begin college under the F CK PGM (he school district pays the tuition at the time the student registers and there is no limit on the number of courses). High school juniors (11 th grade) and seniors (12 th grade) who are ready for college work in one or more subject areas are encouraged to enroll in college level work under the PECDY ELLME P PGM (chool districts reimburse the students for the tuition if they pass the course). tudents are entitled to reimbursement fo two courses per semester. ccording to the law, school districts may voluntarily agree to pay for additional courses beyond two courses per term. PE does not include course enrollments during summer session. High school students 16 years or older may open enroll in college courses as PECL - DEGEE EEKG UDE. here are no limits on the type of course other than academic prerequisites and placement test required for specific courses. Because there enrollments are not state-funded under the chool Finance ct, the student is not entitled to tuition reimbursement by the school district. ection : o be completed by student ame of tudent D Birth Date ddress City tate Zip Code elephone ame of Parent/Guardian chool District Date tudent Enrolled in 9 th Grade / High chool chool D H Principal College erm Year College Course(s): pproved (initials) ake this form to your high school counselor. ection B will indicate which options are available for you. his contract is student and college specific. separate contract must be completed for each college that the high school student plans to attend.
ection B: tudent Eligibility: o be completed by High chool Counselor/principal. Check all that apply. a) his student is a senior who has met or will meet the high school graduation requirements before the start of the college course enrollment. F CK. b) his student is eligible to participate and has the maturity to enroll in a college level course and complete the assignments for the course. c) he school distric agrees to pay the tuition for Fast track courses this term. d) his student is enrolled in 11 th grade. e) his student is enrolled in 12 th grade, f) his student is eligible to participate and has the maturity to enroll in a college level course and complete the assignments for the courses. g) he school district agrees to pay tuition reimbursement for PE courses this term. h) his student is enrolled in grade 13, often referred to as a fifth year senior. ELGBLE for PE i) his is an international student attending high school on an F1visa.ELGBLE for PE j) his student is interested in remedial, pre-college level, or pe courses. ELGBLE F PE k) his student wished to enroll in a course for high school credit only. CLMBLE F FE l) tudent wishes to pay own tuition. Go to section D and sign. igned: Date: itle: For districts that require central administration approval, chool District Central dministration sign below. igned: Date: itle: ection C: pproved by college administrator (or designated college staff who administers high school concurrent enrollment program). Keep copy of signed agreement on file at the college. ame of College pproval tamp or Comments igned: Date: itle: ection D: o be signed by student and student s parent/guardian understand that this agreement entitles me/my child to enroll in college courses. understand the following: 1) he course is a college-level course (i.e., remedial instruction and pre-college level courses are not eligible) and will meet the same course requirements as college students. 2) he course satisfies college graduation requirements (note: Physical education courses, remedial, basic skill courses, and advanced placement courses are not eligible under Fast rack or PE). 3) he course credits will only transfer if earn a C or better in the course. 4) he grade received in this course will appear on my college transcript. 5) f withdraw from the course after the drop/add date, will receive a W or F on my college transcript and will not be eligible for tuition reimbursement. 6) am not eligible for the privileges of a college student, i.e., may not participate in college activities or sports, not eligible for federal or state-funded financial aid, including institutional scholarships funded with general fund dollars. 7) he application entitles me to enroll as a high school concurrent student and does not admit me into the college or a degree program. 8) may be eligible for tuition reimbursement by the school district if meet my district s requirements. Waived if L is checked in ection B. n signing this agreement, authorize the college to release my transcript to my school district at the end of the course. tudent s ignature Parent s ignature Date Date