Form Application Post-Secondary Enrollment: IHCD-E

School District 27J
18551 E. 160th Ave.
Brighton, CO 80601
APPLICATION FOR THE POST-SECONDARY ENROLLMENT OPTIONS PROGRAM

(Due to your high school counselor by November 30th for spring semester classes, and by May 5th for fall semester classes)

NAME______________________________________ DATE OF APPLICATION__________________ ADDRESS___________________________________ HIGH SCHOOL _________________________ ___________________________________________ COUNSELOR ___________________________ TELEPHONE NUMBER _______________________ GRADE AT TIME OF APPLICATION ______

27J SCHOOL ID NUMBER ________________________

STUDENT HAS LIVED IN COLORADO: Years Months _________

Please accept my application to participate in the Post-Secondary Options Program.

I am requesting enrollment in the following institution of higher learning: _____________________________________________________________________________________ _____________________________________________________________________________________Starting Date: _____/_______/__________

I am requesting approval to enroll in the following course(s):

Course Code______________________

Semester_________________________

Name of Course____________________

Credit Hours_______________________

*Attach a description for each course listed

I plan to use the credit earned at the institution of higher learning for:

_____High School Credit Only _____College Credit Only _____High School and College Credit

FOR OFFICIAL USE ONLY

_______ Approved for high school credit. _______ Not Approved for high school credit.

Principal Signature _____________________________________ Date _______________________

Rev. 9/10/10