Eligibility for Concurrent Enrollment 


Date:
	

	

	From:
	

	

	EF/Academy Coordinator
	Student Name:
	

	

	Student ID:
	

	

	Student GPA:
	

	(For Registrar Use Only)
	

The above named student plans to concurrently enroll in community college. The following criteria have been met:
* The student is current with meetings and assignments.
* The student is in good academic standing and is eligible to be concurrently enrolled.


The educational facilitator (EF) and parent or the academy advisor and coordinator have approved any two of the following classes:
Educational Facilitator (EF)/Academy Coordinator/Academy Advisor Use Only
	Main Office Use Only
	Section #
	Course Name
	# of Units
	Grade
	Reimbursable Amount
	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	
Students are allowed to enroll in a maximum of 2 community college classes per semester.


_______________________________________                                _________________
EF/Advisor/Academy Coordinator/Signature                                        Date








Send the Eligibility for Concurrent Enrollment (this form) along with the Concurrent Enrollment Form to the Main Office together.








REPORT OF ACADEMIC CREDITS FOR WORK DONE OUTSIDE THE SCOPE OF THE ACADEMIC CALENDAR OF JCS, Inc. 


(Note: courses taken outside the scope of the academic calendar may be granted academic credit, but not attendance credit)




Student Name: _________________________________        Teacher Name: _____________________________

Grade: ____________                                                  Date of completion: ___________________




Title of course
	Grade
	Credits
	Comments
	Teacher 
Initials
	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	





Teacher Signature


Work Sample Attachments
Please attach to this report evidence of the skills and achievements learned or accomplished in this course. For academic classes, this should be work samples equivalent to one work sample per credit, showing progression of skills development. If a final exam was taken, a copy of that exam may be attached.  For work taken at the community college, a copy of the transcript from the college is sufficient.  If the work is not academic in nature, please attach evidence of the quality and depth of the work and the level of achievement.
________________
JCS, Inc.
LEARNING PLAN FOR ACADEMIC COURSES
TAKEN OUTSIDE THE SCOPE OF THE ACADEMIC CALENDAR
(Note: courses taken outside the scope of the academic calendar may be granted academic credit, but not attendance credit)


Student Name: _______________________________        Teacher Name: ___________________________


Grade: ____________ 


Title of Course
	Academic Credits
	Materials to be used or special circumstances of the course
	

	

	

	

	

	

	

Please list the major concepts, academic or other skills, and abilities which will be addressed in this course: (If this is a core course, the concepts should include those listed in the State content standards)


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_______________________________________________________________________________
Student                                Date


_______________________________________________________________________________
Parent                                Date


______________________________________________________________________________
Educational Facilitator or Advisor        Date                        


 


5021.3 JCS, Inc. Eligibility for Concurrent Enrollment Form                 Last Revised: 03/08/2019                        Page  of 3