Peachtree Ridge High School, Dr. Paul Johnson, Dual Enrollment Coordinator 678-512-6069 or , Office: E108

Student’s Name______Date of Birth______

Student’s High School Name______

Student’s School System Name ______

Anticipated Graduation Date______Current Grade Level______

Dual EnrollmentStudent Participation Agreement FY 2018

The Dual Enrollment program provides opportunities for eligible students in grades 9-12to enroll part- or full-time in postsecondary institutions and take college courses to earn both high school and college credit.

Note: Copies of this completed form shouldbe provided to the students,parents/guardians, and respective postsecondary institution(s).

Note: This completed form should not be forwarded to the Georgia Department of Education or the Georgia Student Finance Commission.

I. Dual EnrollmentRequirements(Reviewed and initialed by Parents/Guardians)

______The student’s Individual Graduation Plan has been updated to reflect the plan of study through the Dual Enrollment program.

______The eligible Dual Enrollment student must contact the high school counselor for approval before any course/schedule changes can be made during the semester/quarter. All Dual Enrollmentcourses and the course grade will become part of the student’s high school permanent transcript.

______The student and parent(s) or guardian(s) acknowledges that should a participating Dual Enrollment student choose to withdraw from a college course prior to midterm, a failing grade will be issued on the students high school transcript. The post-secondary institution transcript will show the withdrawal if done before the withdrawal deadline.

______Dual Enrollment expectations and responsibilities have been shared by the school counselor and all student and the parent/guardian questions/concerns have beendiscussed.

______The parent/guardian acknowledges that the U.S. Department of Education requires that all post-secondary institutionsprovide training on sexual assault awareness and prevention under the Violence Against Women Act.This mandatory training information will beprovided by post-secondary institutions at no costand could includeDual Enrollment students.

______**Astudent participating in the Senate Bill 2 Option must complete all state-required courseworkand any state-required assessmentsassociated with these coursesper the GADOE assessment guidelines/requirement;whether courses are taken at the high school or through Dual enrollment.

I, ______, hereby grant permission for the college/university to release information (Student Name – Please Print)

of myenrollment and grades, including class schedules and transcripts, to my high school counselor or principal, for the purpose ofverifying my high school graduation requirements. This release will remain in effect throughout my enrollment as a Dual Enrollment student.**Senate Bill 2 early graduation course and program requirements will be explained by the high school counselor during the advisement session.

II. Dual Enrollment Semester/Quarter of Participation: This document is required each semester/quarter

TERM:______YEAR: ______

I have applied or plan to apply as a Dual Enrollment student to the following College/Postsecondary Institution(s): ______

III.High School Coursesfor Credit through Dual Enrollment-- Final Schedule Will Be Based On College Availability (To be completed by the Dual Enrollment Coordinator ONLY)

Check Below

_____Part Time Dual Enrollment Student (Combination of DE + High School course(s) to equal full high school schedule)

_____Full TimeDual Enrollment Student(DE Courses-Minimum of 12+ Hours with at least 4+Postsecondary Courses)

High School Course Number and Name / Corresponding College Course on Dual Enrollment Course Directory

IV. Students Pursuing Senate Bill2Option

Check Below

____Associate’s Degree

____Technical College Diploma

____Two (2) Technical College Certificates (TCCs)

Program Study/Major______

V. Dual Enrollment Participation Signatures

StudentName Printed______Date______

Student Signature______

Student Phone Number_________Student Email______

Parent/Guardian Name Printed______Date______

Parent/Guardian Signature______

Parent Phone Number______ParentEmail______

School Counselor Name Printed: Dr. Paul A. JohnsonDate______

School Counselor Signature______

Phone Number: 678-512-6069Email:

VI. General Information

  1. Dual Enrollment classes attended on the college campus follow the college calendar and Dual Enrollment classes attended on the high school campus during their scheduled school day follow the high school calendar.
  2. Students participating in Dual Enrollment college courses should do so with the knowledge that the course work may be more rigorous and challenging than high school courses. Students are held to a higher degree of independent responsibility and accountability than in regular high school classes.
  3. Dual Enrollment students are NOT excused from any classes taken on the high school campus due to the times of their Dual Enrollment courses. Schedules must be arranged so that times do not conflict. The Dual Enrollment Coordinator will make EVERY EFFORT to arrange the high school schedule to avoid such conflicts.