Authorization Form

* fields are required

Form is to be filled out by a school approver only.
Forms filled out by student will not be processed.

Student Information

(Student must be accepted to the College Credit Plus program at Tri-C prior to submission of this form.)

Tri-C ID (S#): *

First Name: *

Last Name: *

SSID:

All correspondence regarding admissions and registration from Tri-C will be communicated to the student via email. Please provide a student email address that is accessible and checked regularly.

Tri-C Email Address:

Personal Email Address: *

Parent/Guardian First Name:

Parent/Guardian Last Name:

Parent/Guardian Email Address:

Parent/Guardian Phone Number:

School Name: *

School District: *

Public/Non-Public: *

CCP Campus: *

Returning CCP student?: *

Yes No

Taking two courses or less?: *

Yes No

Please indicate the specific courses below. If you do not know the courses you wish to take, you will need to make a counseling appointment.

Course #1:

Course #2:

Have you moved to a new school since last semester?: *

Yes No

Academic Information

Administrator: To ensure each student does not exceed full-time status, calculate full-time status as follows:

Determine student's number of high school ONLY units.
Multiple that number by 3.
Subtract the result from the number 30 = CCP Credits Allowed.

School Approver First Name: *

School Approver Last Name: *

School Approver Email: *

School Approver Phone: *

Term: *

Subjects: *

Decimals not allowed; please round down.

Tri-C CCP Credits Allowed this Term: *

Comments:

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Authorization Form

Form is to be filled out by a school approver only. Forms filled out by student will not be processed.

Student Information

Academic Information

Form is to be filled out by a school approver only.
Forms filled out by student will not be processed.