HACC Dual Admission Intent Form

Harrisburg Area Community College (HACC) and York College of Pennsylvania (YCP)

Intent to Enroll Form

By completing this form you are declaring your intention to apply for admission to YCP under the conditions of the HACC and YCP Dual Admission Agreement.

The intent of this Dual Admission Agreement is to provide HACC students with a smooth and successful transition from HACC to YCP.

Application Process

Attend HACC.
Meet with your assigned HACC advisor to review your transfer plan, academic requirements, and academic progression.
Complete Dual Intent to Enroll Form prior to earning 30 credits at HACC.
Submit the required application for admission to YCP as per required deadlines.
Have an official HACC transcript and high school transcript or GED score report sent to the admission office at YCP by required deadlines.
Keep in contact with the YCP transfer advisor or designee.

Personal Information

First Name

Preferred Name

Last Name

Birthdate

Legal Sex

Female

Male

Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Mobile Phone

Opt-in for texting? (for application and event updates - Highly Recommended)

Academic Information

HACC H# (student ID):

HACC Email Address:

Expected HACC Graduation Date

List other colleges or universities attended prior to enrolling at HACC (if applicable).

Student Type

Expected Entry Term at YCP

YCP Program of Interest:

By submitting this form I acknowledge that I have read and understand the requirements outlined within the official dual admission agreement between HACC and YCP. I hereby certify that the statements made or checked on this form are true. I understand that any willful misrepresentation of information may result in the denial of admission. I understand that upon review of the application and meeting of requirements I will be conditionally admitted to YCP until I have met all outlined requirements of the dual admission agreement. I understand I will be required to complete an application for admission to YCP following that institution's application deadlines and requirements. I agree to follow the individual articulated curriculum transfer path to ensure maximum transfer of credits. I authorize HACC and YCP to exchange all information on a regular basis related to my enrollment at either institution for the purpose of maintaining appropriate student records outline by the signed dual admission agreement.

Signature (In place of your signature, please type your full legal name):

Date