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Paul D. Camp Community College

Dual Enrollment Parental Consent Form

July 2019
Both the student and a parent or guardian must sign this form. Fill in all required fields (*), then click Print to PDF at the bottom and save as a PDF to email or submit to the Dual Enrollment Coordinator.

Indicates a required field

Both the student and a parent or guardian must sign this form!
Student Information
Enter a 4-digit year, for example 2026
Enter your age in years
Enter your College SIS ID number if you have one
Student Consent & Signature
As a dual enrollment student, I understand that dual enrollment courses are college courses offered through Paul D. Camp Community College. I am fully aware that the grade(s) I earn in these classes will be part of my permanent college record and could therefore affect my college standing and eligibility for future financial aid or guaranteed admissions agreements.
Parent / Guardian Consent & Signature
As a parent/guardian of the above student, I agree to allow placement testing and enrollment into dual enrollment courses with PDCCC. I understand these classes are located at either the high school, online or at a designated campus or site. Additionally, I understand that dual enrollment classes are college level courses and final grades will be part of my child's permanent college record. I further certify that I and the above student have completed the domicile form included with the application for admission, to determine in-state residency.
The signature of a parent or guardian is required for all students under the age of 18.
dualenrollment@pdc.edu
Dual Enrollment Coordinator

July 2019

When the print dialog opens, choose Save as PDF as the destination.