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Grace Lutheran School

APPENDIX B

Dual Credit Approval Form

2024-25 Dual Credit/Early Admission Course Approval Form

Name of Student: _______________________________
Blinn ID: _______________________________
High School: _______________________________
Class of: _______________________________

I understand that if I am admitted under this program, I will abide by the rules and regulations of the Blinn College District as outlined in the Blinn College District Catalog, which may be found on the Blinn College website, including official registration and withdrawal procedures. I also understand that Blinn College may release my academic record to the high school until I am no longer enrolled at the high school. I further understand that I am not officially enrolled unless all required registration documents and payment have been submitted to the college.

Please provide your parent’s name and email address below. This will enable access of the form to be passed to the parent for their signature via email notification.

Parent’s First Name: _______________________________
Parent’s Last Name: _______________________________
Parent Email Address: _______________________________
Parent Telephone: _______________________________

To be completed by parent or guardian

I agree to these provisions of admission and enrollments hereby listed for consideration of the student’s acceptance and understand he/she must abide by the rules and regulations of the Blinn College District. I understand the student may be exposed to adult material in the classroom and open laboratories, including libraries, learning centers and computer labs.

I understand that once the student is registered in a college course he/she is under the rules of the Family Educational Rights and Privacy Act (FERPA), and I may not have access to my student’s records without his/her written permission on the FERPA release form.

Student Signature: _______________________________
Date: _______________________________
Parent/Guardian Signature: _______________________________
Date: _______________________________

Course Request

Please complete the course request below.

Course Name	Semester	CRN	Day/Time
_______________________________	_______________________________	_______________________________	_______________________________

For academic dual credit, I certify the student has attained an "80" or better average on all schoolwork attempted. For technical dual credit, I certify the student has attained a "70" or better average on all schoolwork attempted.

Signature of High School Principal or Designee: _______________________________
Date: _______________________________
Signature of College Designee: _______________________________
Date: _______________________________

Completed by Blinn College Official