iCAN- New Student - Fall 2023 COC Dual Enrollment Student Contact Questionnaire
Please complete the below questionnaire to receive the required COC Dual Enrollment Special Admission Form by email.
Student Last Name - As submitted on the Fall 2023 COC Application *
Student First Name - As submitted on the Fall 2023 COC Application *
High School Student ID number. Note: If you do not have a Hart District Student ID number, please enter 00000000. *
Grade Level for Fall 2023 *
Hart District Student Email - The COC Dual Enrollment Special Admission Form will be emailed to this address. Note: If you do not have a Hart District student email address, please enter a personal email address (gmail, yahoo, icloud) that you regularly monitor. Do NOT use your Castaic Middle School email address.  *
Confirm Hart District Student Email (email listed above) *
Parent/Guardian Email - The COC Dual Enrollment Special Admission Form will be emailed to this address for parent approval. *
Confirm Parent/Guardian Email *
Preferred Student Phone Number *
Please confirm you have completed ALL of the COC Dual Enrollment Student Checklist steps listed below. Completion of Step 1 - Step 3 is REQUIRED before your COC Dual Enrollment Special Admission Form can be emailed to you. *
Yes
No
Step 1: Submitted a Fall 2023 COC Application
Step 2: Activated Canyons ID account
Step 3: Completed Online Orientation
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.  *
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