Fall - 06/15 Spring - 11/15 Summer - 03/10

In addition to completion of this survey, the following paperwork is required for enrollment in the Dual Credit program: 1) Dual Credit Waiver Approval Form (complete online) 2) Student Commitment Statement (complete online) 3) Test Scores (submitted by high school) 4) Official High School Transcript (submitted by high school)

Students with documented disabilities are encouraged to apply for accommodations during one (1) of the following: 1) If you require Testing Accommodations for the TSI Placement Test (other than extended time: test is untimed) or 2) If you have already registered for your courses and require Classroom Accommodations. Steps to Receive ADA (504) Accommodations Obtain appropriate documentation of your disability. Appropriate documentation is required for the intake appointment and before accommodations can be provided. For a Learning/Intellectual Disability: 1) Most recent diagnostic assessment including: Diagnosis, Intelligence and achievement test results 2) Most recent full and individual evaluation *ARD documentation alone may not be sufficient For Other Disabilities: 1) Recent comprehensive medical, physical, or psychological evaluation or 2) Typed letter on office letterhead with a signature from a licensed professional (MD, Psychologist, Psychiatrist) including the following: ----> Diagnosis ----> Functional limitations ----> How it impacts your educational process Call and Schedule an Intake Appointment with the ADA Counselor listed below and remember to present your documentation. The ADA Counselor will review your documentation and determine eligibility for services. Please remember to visit your ADA Counselor each semester to obtain a current accommodation letter. ADA Counselor Dana Denson Email: dana.denson@hccs.edu Phone: 713/718-5854

Associate Degree - an Associate degree prepares students for academic transfer to a public university or college where they can earn credit towards a four-year degree.

Level I Certificate - a certificate in a specialized career field will help a student gain skills for job advancement.

Student Acknowledgement By checking the box below, I am providing consent for enrollment to occur in the Dual Credit program.

I will make a commitment to my academic success and myself: To attend class: • I understand the importance of attending classes regularly, to be on time and stay until the end of class. • I understand that I must attend the required class time specified by the college. To participate: • I commit to actively participate in class as this is very important to my learning experience and to my classmates. • As part of this commitment I understand that I must respect others and avoid cellphone use or other disruptive behaviors. • I will actively use my HCC email and Canvas account regularly to communicate with college personnel. To prepare for class and study: • I will ensure that I read the course syllabi; I am prepared with all study materials and study independently to get ready for each class as required for the class. • I will complete all assignments on time, demonstrate organization, time management, a strong work ethic and a willingness to learn. • I also understand that my classes may require several hours of independent studying per week. To be successful: • I will go to the instructor with any questions or concerns about the class to ensure my success in class and to follow college policy. • I will use other campus resources, such as Tutoring, Library and Center for Learning Resources to support my studies. • I understand that plagiarism and cheating are unethical and will submit work that is properly documented and solely mine. • I want to be proud of the work I do and the college credit I earn. To be positive: • I understand that I will be in a college environment where the class rigor may challenge me, I will remain positive and understand that this is a necessary part of learning. • I commit to strive to embrace difficulty with optimism.

Student Acknowledgement I understand that I can only succeed through hard work and will take the initiative in my education. Because I want to succeed in this program, I will apply the above commitment, as the support to my success. I understand that the ultimate responsibility for succeeding is in my control. I 100% commit.