Fall 2024 Dual Enrollment Student Contact Questionnaire
Please complete the below questionnaire to receive the required Dual Enrollment Special Admission Form by email.
Student Last Name (As submitted on COC Fall Application) *
Student First Name (As submitted on COC Fall Application) *
Hart District Student ID number *
Grade Level *
Hart District Student Email - The Dual Enrollment Special Admission Form will be emailed to this address. *
Confirm Hart District Student Email *
Parent/Guardian Email - The Dual Enrollment Special Admission Form will be emailed to this address for parent approval. *
Confirm Parent/Guardian Email *
Preferred Student Phone Number *
Do you have an IEP/504? If yes, we will follow up with information on how to receive services from COC's Academic Accommodations Center (AAC). Please note: K-12 IEP/504 plans cannot be transferred to college courses. Students will need to meet with AAC to see what accommodation(s) they may be eligible for. *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms