Returning YCP Dual Enrollment Students

Personal Background

Email Address (personal, not YCP)

YCP ID#

First Name

Last Name

Birthdate

Cell Phone Number

Home Phone Number

Do you need to update your address?

Yes

Mailing Address

Country

Street

City

Region

Postal Code

Plan of Study

Which Semester?

Spring 2021

Summer 2021

Fall 2021

Do you participate in YCCOSP?

Yes

Parent/Guardian Information

Parent/Guardian #1

First Name

Last Name

Email Address

Do you live with Parent/Guardian #1?

Yes

An email will be sent to your parent(s)/guardian(s) to consent for you to participate in Dual Enrollment for the semester on this application.

Parent/Guardian #2

First Name

Last Name

Email Address

Do you live with Parent/Guardian #2?

Yes

High School Counselor Information

An email will be sent to your High School Counselor to fill out and return with your transcript.

First Name

Last Name

Email Address

High School Graduation Year

Student Agreement and Consent

I authorize York College to furnish my high school any and all information pertaining to my academic record while I am enrolled in York College as a Dual Enrollment student. I hereby release York College from any liability or damage that may result from furnishing the information requested.

I understand that as a dual enrollment student, I must comply with all College policies including requirements for attendance, class and campus behavior.

I understand that dual enrollment students do not qualify for college financial aid and payment of tuition is my responsibility. Additionally, the cost of books and transportation to and from York College is my responsibility. Any collection costs or legal fees if applicable are my responsibility as the student.

I understand by signing this Registration Form I am financially obligated to pay for the course; non-attendance will not remove my charges. I am aware that I must complete a withdrawal form if I wish to leave the course and a refund will not be provided. Should I decide to withdraw from a course, I must notify my high school counselor.

I understand in order to receive college credit at another institution, I need to request and pay for an official York College transcript from the Records Office to be mailed to the college/university that I plan to attend. It is up to the receiving college/university to determine the transferability of those course(s).

From time to time, photographs or video images may be taken at various program activities and those photos and images may be used by York College of Pennsylvania in promotional materials without compensation or further agreement.

I further affirm all claims regarding my legal residence are correct and honestly presented. I have no intention to willfully defraud the College.

In place of your signature, please type your full legal name