Dual Credit Registration Packet

Dual Credit Registration Packet

College of Western Idaho

2013-2014 Academic Year

General Information and Policies

Student Eligibility Eligible students must have reached junior standing, the minimum age of 16 years prior to the end of the term in which the student enrolls, or successfully completed at least one-half of the high school graduation requirements as certified by the high school. Students who do not meet the above criteria can petition by completing the Sophomore by Exception Form (included in this packet) or by contacting the CWI Dual Credit Office.

Courses Offered Students may take courses at their high school, on the CWI campus, or online. Courses offered at high schools will vary by school. Students should contact their high school counselor for a complete list of courses offered. Many CWI courses, online or at any of our campus locations, are available to Dual Credit students. All course prerequisites still apply for Dual Credit students.

COMPASS Testing Placement test scores are used to ensure students register into appropriate course-work. If you do not have ACT/SAT scores, or do not have college coursework in math and English you will need to take the COMPASS before you can register for any math or English course on campus or online. Students who do not attend an accredited high school, will also be required to take the COMPASS prior to registration into any Dual Credit course. Visit the CWI Assessment Services website for additional infor-mation on COMPASS testing.

Tuition and Fees CWI Dual Credit students are charged $65 per credit for any dual credit course, re-gardless of whether the course is taken at the high school, online, or on campus. Some courses may have additional fees, i.e. lab fees, supplies and material fees. Online courses do assess an additional $10 per credit fee.

Textbooks and Course Materials Although some high schools offering Dual Credit coursework may provide books and materials for their students, all materials or textbooks required for a course are the responsibility of the student.

Class Attendance and Behavior Students participating in the CWI Dual Credit program are subject to the same attendance and behavior policies required of all enrolled students. Disciplinary matters will follow procedures outlined in the College of Western Idaho’s Stu-dent Handbook. It is the student’s responsibility to read and understand the CWI Student Handbook.

(General Information and Policies continued on back cover)

Did you know?Did you know?

High school students can take High school students can take

courses on the CWI campus or courses on the CWI campus or

online for $65 per credit.*online for $65 per credit.*

*Other course fees may apply and vary by course and deliv-*Other course fees may apply and vary by course and deliv-ery method.ery method.

The CWI general class schedule, which can be found at The CWI general class schedule, which can be found at

http://cwidaho.cc/currenthttp://cwidaho.cc/current--students/classstudents/class--schedule, shows schedule, shows

students all available on campus and online courses. In students all available on campus and online courses. In

addition to those courses, the online courses below have addition to those courses, the online courses below have

seats reserved just for CWI Dual Credit students. Contact seats reserved just for CWI Dual Credit students. Contact

the CWI Dual Credit Office to check availability and capacity.the CWI Dual Credit Office to check availability and capacity.

Fall 2013 Online Dual Credit Reserved SectionsFall 2013 Online Dual Credit Reserved Sections

COMM 101 001DWCOMM 101 001DW——Fund. Of Oral Communication (3cr.)Fund. Of Oral Communication (3cr.)

ENGL 101 001DWENGL 101 001DW——English Composition I (3 cr.)English Composition I (3 cr.)

ENGL 102 001DWENGL 102 001DW——English Composition II (3cr.)English Composition II (3cr.)

HIST 111 001DWHIST 111 001DW——United States History 1 (3 cr.)United States History 1 (3 cr.)

MATH 143 001DWMATH 143 001DW——College Algebra (3 cr.)College Algebra (3 cr.)

POLS 101 001DWPOLS 101 001DW——American National Government (3 cr.)American National Government (3 cr.)

PSYC 101 001DWPSYC 101 001DW——General Psychology (3 cr.)General Psychology (3 cr.)

Spring 2014 Online Dual Credit Reserved SectionsSpring 2014 Online Dual Credit Reserved Sections

ENGL 101 001DWENGL 101 001DW——English Composition I (3 cr.)English Composition I (3 cr.)

ENGL 102 001DWENGL 102 001DW——English Composition II (3 cr.)English Composition II (3 cr.)

HIST 101 001DWHIST 101 001DW——Western Civilization 1Western Civilization 1

HIST 112 001DWHIST 112 001DW——United States History 2 (3 cr.)United States History 2 (3 cr.)

MATH 144 001DWMATH 144 001DW——Trigonometry (2 cr.)Trigonometry (2 cr.)

POLS 101 001DWPOLS 101 001DW——American National Government (3 cr.)American National Government (3 cr.)

SOCY 101 001DWSOCY 101 001DW——Introduction to Sociology (3 cr.)Introduction to Sociology (3 cr.)

Understanding Policy!Understanding Policy!

In order to ensure the most successful and positive In order to ensure the most successful and positive Dual Credit experience for you, it is important that Dual Credit experience for you, it is important that you read and understand all information and policies you read and understand all information and policies included in this packet. Please ensure you familiarize included in this packet. Please ensure you familiarize yourself with all pertinent dates, deadlines, and poli-yourself with all pertinent dates, deadlines, and poli-cies.cies.

In-person, deliver forms to:

CWI Dual Credit Office 5500 East Opportunity Drive

NCAB Room 107 Nampa, Idaho 83687

Mailed forms should be sent to:

CWI Dual Credit MS 2000

PO Box 3010 Nampa, Idaho 83653

Student Checklists and Important Dates

Scholarship Deadline All scholarships and supplemental materials are due in the dual credit office. Applications not filled out completely or accompanied by required supplemental materials will not be considered for an award.

Fall 2013: Friday, September 13 Spring 2014: Friday, February 7

Registration Deadline Registration Packet due in dual credit office including:

□ Dual Credit Registration Form □ Certificate of Residency/Affidavit □ DC Permission to Release Education Record □ Sophomore By Exception Form (if under 16) All documents must be filled out completely including parent and school signatures where required.


High School Course Payment Deadline A $50 late fee will be assessed to all student accounts not paid in full by the payment deadline.

Fall 2013: Friday, October 25 Spring 2014: Friday, March 21

High School Drop and Refund Deadline Students dropping classes on or before this date will be able to do so without receiving a “W” on their transcripts. Students may receive a full refund for classes dropped by this deadline.

Fall 2013: Friday, November 1 Spring 2014: Friday, March 28

High School Withdrawal Deadline Students choosing to drop classes after the drop date but before the withdrawal deadline will receive a “W” on their transcripts. Students may not exit a course after this deadline.

Fall 2013: Friday, November 15 Spring 2014: Friday, April 11

High School Dual Credit Course Checklist and Deadlines

Scholarship Deadline All scholarships and supplemental materials are due in the dual credit office. Applications not filled out completely or accompanied by the required supplemental materials will not be considered for an award. Students taking regular college courses may apply for dual credit scholarships, but will need to pay for the course by the regular CWI deadlines. Scholar-ships will be awarded in the form of a refund to the student.


Online/On Campus Registration Deadline Registration Packet due in dual credit office including:

□ Dual Credit Registration Form □ Certificate of Residency/Affidavit □ DC Permission to Release Education Record □ Sophomore By Exception Form (if under 16) All documents must be filled out completely including parent and school signatures where required.

Fall 2013: Friday, August 23 Spring 2014: Friday, January 17 Summer 2014: Friday, May 30

Online/On Campus Payment Deadline A $50 late fee will be assessed to all student accounts not paid in full by the payment deadline. Students seeking scholarships will need to pay for courses on or before this deadline and will be refunded if awarded a scholarship.

Fall 2013: Monday, August 19 Spring 2014: Monday, January 13

Summer 2014: Wednesday, May 28

Online/On Campus Drop and Refund Deadline Students dropping classes on or before this date will be able to do so without receiving a “W” on their transcripts. Students may receive a full refund for classes dropped by this deadline

Fall 2013: Monday, September 9 Spring 2014: Monday, February 3

Summer 2014: Friday, June 6

Online/On Campus Withdrawal Deadline Students choosing to drop classes after the drop date but before the withdrawal deadline will receive a “W” on their transcripts. Students may not exit a course after this deadline.

Fall 2013: Friday, November 15 Spring 2014: Friday, April 11 Summer 2014: Friday, July 11

CWI Online/On Campus Checklist and Deadlines

Online/On Campus Registration for DC Students Begins

Fall 2013: Monday, April 22 Spring 2014: Monday, November 25

Summer 2014: Monday, April 28

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These checklists were created to guide students through important deadlines. While the checklist is a useful tool, students are responsible for reading and

understanding all CWI Dual Credit processes outlined in the CWI Dual Credit registration packet.

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Students must meet each deadline by 5:00pm on the day each task is due. All payments and paperwork must

be turned in at the CWI Dual Credit Office.

If you have questions or need assistance call the CWI Dual Credit office at (208) 562-3371.

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Dual Credit - 208.562.3371 phone - 208.562.3530 fax MS 2000 - P.O. Box 3010 - Nampa, ID 83653 - www.cwidaho.cc

DUAL CREDIT REGISTRATION FORM

This form is used for current high school students registering for Dual Credit courses offered at their high school or traditional courses offered at any CWI campus location or online. The acceptance of CWI credits as high school credits is at the discretion of the local secondary school district. It is the responsibility of the student to ensure that the credits earned through this program will be accepted by their high school.

In addition to this Registration Form, Dual Credit students must complete and return the Certificate of Residency and Permission to Release Education Record form each semester in which they are enrolled.

REQUIRED PERSONAL INFORMATION

_____________ LAST NAME FIRST NAME M.I. CWI STUDENT ID -OR- SOCIAL SECURITY NUMBER

_____________ MAILING ADDRESS CITY STATE ZIP COUNTY

____ ____ _______ PHONE NUMBER (INCLUDING AREA CODE) DATE OF BIRTH (MM/DD/YYYY) CITIZENSHIP COUNTRY

EMAIL ADDRESS CELL PHONE (OPTIONAL)

_____________ NAME OF HIGH SCHOOL HIGH SCHOOL GRADUATION DATE (MM/YYYY)

OPTIONAL INFORMATION

Gender: _____Male _____Female Are you Hispanic or Latino? _____Yes _____No

Race: _____American Indian/Alaska Native _____Asian _____Black/African American _____Hawaiian/Pacific Islander _____White

COURSES AND PAYMENT INFORMATION

Semester: Fall 20_____ Spring 20_____ Summer 20_____

Dual Credit courses are currently $65 per credit hour (see chart below), additional course fees may apply. Online courses are also assessed a $10 per credit fee. Payment deadlines are different for courses taken on-campus or online than courses taken at a student’s high school. For information on payment deadlines associated with courses taken on-campus or online, please view the CWI Academic Calendar located on p.6 of the CWI Catalog. Dual credit courses taken at a high school location will follow the calendar and deadlines included in this packet. Formore information please contact the Dual Credit Office directly.

Subject Course # Section Title Credits Instructor Signature* Total Cost for Course

ENGL 101 003D English Composition I 3 John Doe $195

$

$

$

$

Total $

Payment Method: _____ Check (attached) _____ Money Order (attached) _____ Credit Card Payment, please contact the Dual Credit Office.

*Instructor signature is required for high school courses only. By signing in the field above, the instructor is approving the student into the course and verifying that the student has met all prerequisites and placement requirements for their course.

FOR HIGH SCHOOL TO COMPLETE

I certify that the above student is at least 16 years of age, has completed at least half of his/her high school graduation requirements, or has completed and included the Sophomore by Exception form with all necessary supporting documents. Additionally, I certify that the student has at least a 2.0 cumulative GPA and the high school’s permission to enroll in the above CWI courses. I understand that it is the responsibility of the high school, not CWI Dual Credit, to apply the above classes toward high school graduation requirements.

Check here if the student is participating in the “Early Completer Program” and their enrollment costs will be paid by the high school.

HIGH SCHOOL OFFICIAL’S NAME HIGH SCHOOL OFFICIAL'S SIGNATURE DATE

1 credit course 2 credit course 3 credit course 4 credit course 5 credit course

$65 $130 $195 $260 $325

(REGISTRATION FORM IS CONTINUED ON REVERSE)

CWI delivers college credit instruction, certificates and degrees through its memorandum of understanding with College of Southern Idaho (CSI).

CSI is accredited through The Northwest Commission on Colleges and Universities (NWCCU).

(CONTINUED FROM DC REGISTRATION FORM PREVIOUS PAGE)

DUAL CREDIT PAYMENT AGREEMENT

By signing at the bottom of this page, you acknowledge that you have read, understand, and agree to the terms outlined below.

Personally responsible – I understand and agree that I owe the full amount of the balance on my account and am personally responsible for making all necessary payments to CWI. I understand that I have the right to pay the outstanding balance in a lump sum any time prior to the payment deadline.

Financial Aid – In the event that I receive scholarships or any other financial assistance, I understand and agree that CWI will use those funds to reduce or pay off any allowable outstanding balance owed to the College first and will only issue a refund to me once the outstanding balance owed has been paid in full. If I do not receive a scholarship or scholarship funds are pending, I understand that I am personally responsible for making the payments due on my account according to the appropriate course payment deadline.

Drop for Nonpayment – I understand and agree that if I fail to make any payment prior to the payment deadline, a $50 late fee will be applied to my account and I may be dropped for nonpayment after 5pm on the drop deadline. Being dropped for non-payment is not a guarantee nor the responsiblity of the College of Western Idaho, and will not replace the student's requirement to submit an Add/Drop Form to the Dual Credit Office for any course I intend to drop by the nedessary deadline. If you are dropped for nonpayment, no grades or official academic transcripts will be awarded. Students seeking reinstatement after being dropped for nonpayment will be charged a reinstatement fee of $10 per credit up to $120.

Failure to Pay – I understand and agree that if I reinstate my registration after being dropped for nonpayment, and I fail to pay my account balance in full by the withdrawal deadline, I will be in default. In such event, CWI will, without further notice to me, call the entire outstanding balance due and payable immediately. In the event of default, CWI will refer the outstanding balance to an independent collection agency. I agree to and will be personally responsible for the full amount referred to the collection agency and understand the collection agency may charge me for all costs of collection. If I am a minor, under the age of 18, I must obtain an adult cosigner who will be responsible for the full balance on my account, and any collection fees as described herein.

Holds – In the event of default, in addition to any other legal or equitable remedy allowed by law, which CWI hereby expressly retains, CWI reserves the right to withhold official academic transcripts, grades, diplomas, certificates, registration for subsequent semesters, payroll checks, or any other services not specifically listed herein.

Dropping a Course/ Withdrawal - I understand that if I choose to drop a course after signing this agreement, I am entitled to a 100% refund of the tuition if I do so PRIOR to the census date published in the official academic calendar for courses taken on-campus or online. For dual credit courses being taught within a high school location, this must be completed PRIOR to the drop and refund deadline given in the CWI Dual Credit Registration Packet. If I withdraw from a course after the drop and refund deadline, I will be held responsible for the full tuition and fees related to that course.

I will inform CWI within ten (10) days of any changes in my home address, phone number, or status as a student at CWI.

COSIGNER (REQUIRED FOR STUDENTS UNDER 18)

The undersigned cosigner, often the parent or legal guardian, to the Dual Credit Payment Agreement (above) hereby agrees to be bound to all terms and conditions stated within the aforementioned Dual Credit Payment Agreement. The undersigned further acknowledges and agrees that, by signing this document, I am personally responsible for all amounts owed in accordance with this agreement.

COSIGNER’S NAME (LAST, FIRST, MI)

MAILING ADDRESS CITY STATE ZIP

PHONE NUMBER (INCLUDING AREA CODE)

COSIGNER’S SIGNATURE DATE

STUDENT AND PARENT CONSENT

I have read all the information provided within the Dual Credit Registration Packet. I understand the conditions of enrollment and the expectation of participation within dual enrollment courses. I understand that it is the responsibility of the student to make themselves aware of all CWI Dual Credit policies. To facilitate this program, I hereby give permission for CWI to release all student account information, including financial, academic, and enrollment records, to the student’s high school, and the high school to release grades to CWI.

STUDENT SIGNATURE DATE PARENT/GUARDIAN SIGNATURE DATE

Rev. 12-03-2009

CERTIFICATE OF RESIDENCY/AFFIDAVIT For county of:

If the county cannot certify your legal residency, you are responsible for paying the county portion of your tuition.

Idaho code 33-2110 requires that the county you resided in for at least 12 consecutive months prior to attending classes pay part of your tuition (except for Ada and Canyon counties if attending CWI). It is your responsibility to prove legal residency by completing the form below. Some counties may require additional information or have you complete additional forms.

PLEASE COMPLETE ALL ITEMS BELOW:

Name: Last: First: Middle: Phone:

Term: Fall 20 OR Spring 20 Birth Date: SSN:

Current Address:

Resident County Address:

I have lived at the Resident County Address in county from to

Name of property owner where you live:

High School Last Attended: Dates Attended:

Parent or Spouse: Phone: I hereby make application for tuition assistance to attend the College of Western Idaho for the term of entry noted above. I certify to the best of my knowledge that all statements I have made in this application are complete and true.

Student’s Signature: Date:

CHECK ALL THAT APPLY

I am a registered voter in this county.

My vehicle is registered in this county – License Plate #:

I have resided in this county for at least 12 consecutive months prior to the start of the college term in which I am enrolling.

I am a resident of this county, but have been living in another county for less than one year and have not established residency outside this county.

My parent/guardian has resided in this county for at least 12 consecutive months prior to the start of the college term in which I am enrolling.

I or my spouse am residing, or are a dependent of a person residing in this county on military orders. Attach a copy of those orders.

For County Use Only Below this Line

This is to certify that the above named person is a legal resident of the county of , State of Idaho, and is eligible for tuition aid from this county for the academic year.

By: Board of County Commissioners Attest: Date:

Upon completion, the county will return to: College of Western Idaho PO Box 3010 Nampa, ID 83653 Fax: 888-562-0456




DUAL CREDIT PERMISSION TO RELEASE EDUCATION RECORD

Use this form to authorize the College of Western Idaho to release your specified student information to individuals you designate. If you wish to allow CWI to release information abut your education record to your parent or other designee, this form must accompany the DualCredit Registration Form and the Certificate of Residency/Affidavit every term the student registers for coursework. This form must be COMPLETE and signed by the student; otherwise it will be recorded as invalid and voided.

THIS FORM IS FOR HIGH SCHOOL STUDENTS PARTICIPATING IN DUAL CREDIT COURSEWORK ONLY.

_____________ STUDENT’S LAST NAME STUDENT’S FIRST NAME M.I. CWI STUDENT ID -OR- SOCIAL SECURITY NUMBER

____ ____ _______ PHONE NUMBER (INCLUDING AREA CODE) DATE OF BIRTH (MM/DD/YYYY)

RELEASE EDUCATION RECORD INFORMATION TO: (RECIPIENT)

Recipient 1 Recipient 2

__________ ____________ LAST NAME FIRST NAME M.I. LAST NAME FIRST NAME M.I.

___ _____ RELATIONSHIP/ORGANIZATION RELATIONSHIP/ORGANIZATION

___ _____ ADDRESS ADDRESS

___ _____ CITY, STATE, ZIP CITY, STATE, ZIP

TO ___ TO BEGINNING DATE ENDING DATE BEGINNING DATE ENDING DATE

(Dates must be provided and may not exceed One Year.) (Dates must be provided and may not exceed One Year.)

EDUCATIONAL RECORD TO BE RELEASED

This form will be voided if the section below is not completed. Please indicate which record(s) you authorize to be released:

Financial Records (Scholarship Awards, Business Statements, etc.) Academic Records (Grades, Transcripts, etc.)

Schedule Enrollment Information

PURPOSE OF RELEASE

This form will be voided if the section below is not completed. Please indicate the purpose of this release of records:

Family Communication Admission to an Educational Institution Current/Potential Employer Emergency Contact Information

STUDENT CONSENT AND SIGNATURE

I give permission to the College of Western Idaho to release the specified information to the recipient(s) listed above. I understand that this information is considered part of a student education and/or financial record. Further, I understand that by signing this release I am waiving my right to keep this information confidential under the Family Education Rights and Privacy Act (FERPA). I certify that my consent for disclosure of this information is entirely voluntary. I understand this consent for disclosure of information can be revoked by me in writing at any time, but will not affect the information released under my previous consent. If I wish to make any changes to my consent for release, I understand I will need to complete and file a new form. I acknowledge that this form will be considered invalid upon the termination of my involvement in the CWI Dual Credit program, and that a Permission To Release Education Record Information form must be submitted through the CWI One Stop Services to authorize release of student information once I begin attending as a full-fee paying, traditional student.

STUDENT SIGNATURE DATE



RG-Student Dual_Credit_Form_11172011


DUAL CREDIT SOPHOMORE BY EXCEPTION – PARENT CONSENT

This form is only for high school students who do not meet the CWI Dual Credit eligibility criteria due to either age or grade level. Submission of this form does not guarantee approval of the applicant to participate in the Dual Credit program.

Please submit this form in addition to the Registration Form(s), the Certificate of Residency, and the Permission to Release Education Record form.

REQUIRED STUDENT INFORMATION

_____________ LAST NAME FIRST NAME M.I. STUDENT ID -OR- SOCIAL SECURITY NUMBER


____ ____ _______ PHONE NUMBER (INCLUDING AREA CODE) DATE OF BIRTH CITIZENSHIP COUNTRY

_____________ NAME OF HIGH SCHOOL PHONE HIGH SCHOOL GRADUATION DATE (MM/YYYY)

PARENT ACKNOWLEDGEMENTS

Courses will be more academically challenging than traditional high school courses

Student may be exposed to discussions, readings, and visual material of a mature nature and will be expected to conform to the sameperformance standards as any other college student as set forth in course outlines and syllabi

The student will not be allowed to continue in the dual credit program if he/she earns a grade of D or F in any Dual Credit class

If a student plagiarizes a paper, or colludes or cheats in any dual credit class, the student will be subject to the disciplinary policies and procedures of the college up to and including failure of the course and suspension from the dual credit program.

The college and its employees, faculty, agents, students, and trustees shall not be responsible for the supervision and individualmonitoring of student while in attendance at the college.

PARENT RESPONSIBILITIES

Certify student is of sufficient maturity to complete college level material

Certify student is able to study independently

Certify student is able to interact socially with adult, college students and the college is not responsible for these interactions

Follow up with students to be sure they complete and submit appropriate paperwork

Remind students they will be developing a permanent college academic record

Submit payment to CWI for all coursework taken

PARENT/LEGAL GUARDIAN CONSENT

I, _____________ _______, hereby understand the parent acknowledgements and responsibilities and will adhere to them. Furthermore, I grant my child, _____________ ______, permission to enroll in the Dual Credit program at the College of Western Idaho.

___________________________________________________________ ___________________ Parent or Legal Guardian Signature Date

HIGH SCHOOL SIGNATURE OF SUPPORT

By signing below, I confirm that the student has a minimum CGPA of 2.5. Additionally, I give my support to this student to participate in the CWI Dual Credit Program. I also acknowledge that I have reviewed the CWI Dual Credit Registration Packet and the included information with the student. I have informed the student of my willingness to support them throughout their participation in this program.

_____________ ______________________________________________________HIGH SCHOOL OFFICIAL'S SIGNATURE DATE

*Home school students must have signature of the home school education provider/administrator.




CWI DUAL CREDIT SCHOLARSHIP APPLICATION FORM

It is the responsibility of the student to ensure that their scholarship application and supporting materials are received in the CWI Dual Credit Office by 5PM the day of the scholarship deadline for the term in which they intend to apply, see below:

Fall 2013 Scholarship Deadline: Friday, September 13 Spring 2014 Scholarship Deadline: Friday, February 7

PLEASE RETURN ALL SCHOLARSHIP MATERIALS AND APPLICATIONS IN PERSON OR BY MAIL DIRECTLY TO THE CWI DUAL CREDIT OFFICE. IT IS EXPECTED THAT STUDENTS WILL BE RESPONSIBLE FOR THE

SUBMISSION OF THEIR SCHOLARSHIP MATERIALS, NOT THEIR HIGH SCHOOLS.

REQUIRED PERSONAL INFORMATION

_____________ LAST NAME FIRST NAME M.I. STUDENT ID -OR- SOCIAL SECURITY NUMBER


____ ____ _______ PHONE NUMBER (INCLUDING AREA CODE) DATE OF BIRTH CITIZENSHIP COUNTRY

_____________ NAME OF HIGH SCHOOL PHONE HIGH SCHOOL GRADUATION DATE (MM/YYYY)

COURSES REQUESTED FOR SCHOLARSHIP

Semester: Fall 2013: Spring 2014:

Subject Course# Section Title Credits Total Cost for Course

$

$

Total $

STUDENT SCHOLARSHIP REQUEST LETTER

Attach a professional letter, one page in length, introducing yourself as an applicant for this scholarship and why you believe you are deserving of this academic award. Please include information on any educational activities, extracurricular activities, and community involvement. This must be a typed document.

HIGH SCHOOL TRANSCRIPT

Student must submit along with this application form a current copy of their high school transcript, unofficial copies will be accepted.

STUDENT SIGNATURE

I agree that all information provided on this application is accurate to the best of my knowledge. I further understand that completion of this application is not a guarantee of award and that I will be responsible for any fees associated with my Dual Credit registration regardless of the result of this application.

________________________________ ______________ STUDENT SIGNATURE DATE

Revised April 2013

Dual Credit Scholarship Application Provided by the College Access Challenge Grant

Submit this application directly to the institution’s Dual Credit/Concurrent Enrollment Coordinator: Boise State University Kristi Lakatos Extended Studies 220 E. Parkcenter Blvd. Boise, Idaho 83706-3940 208-426-3294

College of Southern Idaho John Miller Taylor 251 P.O. Box 1238 Twin Falls, ID 83303-1238 208-732-6280

College of Western Idaho Eric Studebaker MS 2000 P.O. Box 3010 Nampa, ID 83653 208-562-3247

Northwest Nazarene University Cindy Roberts Concurrent Credit/Express Ed. Program 623 S. University Blvd. Nampa, ID 83686 208-467-8373

Idaho State University Chelsie Rauh Early College Program 921 S 8th Avenue, Stop 8057 Pocatello, ID 83209-8057 208-282-6067

Lewis-Clark State College Rachel Peasley RCH 114, 500 8th Ave. Lewiston, ID 83501 208-792-2378

North Idaho College Virginia Winckler Molstead Library 201I 1000 West Garden Avenue Coeur d'Alene, ID 83814 208-769-3229

University of Idaho Linda Gollberg Education Building, Room 217A PO Box 443099 Moscow, ID 83844-3099 208-885-4074

The College Access Challenge Grant (CACG) is a grant designed to foster partnerships among Federal, State and local government entities and philanthropic organizations to significantly increase the number of underrepresented students who enter and remain in postsecondary education. CACG provides grants to states to meet the needs of underrepresented students and families. Idaho’s CACG will give direct support to students by providing tuition assistance and/or textbooks for dual credit courses. Underrepresented students will be identified through a brief application process initiated by school staff and sent to the Dual Credit Coordinator.

Please note: A request for funds is not a guarantee of funding. Students are responsible for dual credit tuition costs not funded by CACG. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED FOR FUNDING!

Student Information

Name: (Last, First, MI) ______________________________________________________________________________________________________

Year in school: Freshman ❏ Sophomore ❏ Junior ❏ Senior ❏

Address: ______________________________________________________________________________________________________________ Street City State Zip

Date of Birth: ____________________________________ Social Security Number: ___________________________________________ Please indicate: ❏ I qualify for free or reduced lunch ❏ I do not qualify for free or reduced lunch

(complete financial need statement)Student Request

NOTE: Requests should be for one class only. The State Board of Education will not award scholarships for more than one class during the academic term.

Course Title/Number: _____________________________ Credits: ________________ Amount: ________________________ Counselor Certification

This student has been recommended for scholarship support by their building administration based on the fact they meet the need criteria noted above and the academic criteria established to participate in dual credit programs. Current High School GPA: _____________________ High School: ____________________________________________________________

Counselor Signature: ____________________________________________________________________________ Date: __________________ Student Certification

I certify that this application is correct to the best of my knowledge. I give my consent for the institution’s representative to share this information with the Office of the State Board of Education for the purpose of awarding scholarships and evaluating the program.

Student Signature: ______________________________________________________________________________ Date: _________________

Parent Signature: _______________________________________________________________________________ Date: _________________

For Institution Use Only I verify that I have reviewed and support this application and that the student meets the institutional criteria established to participate in dual credit courses. DC Coordinator Signature: _______________________________________________________________________ Date: __________________

April 2013

Statement of Financial Need 2013 – 2014

Attach this certification to the Dual Credit Scholarship Application to be considered for a dual credit scholarship through the College Access Challenge Grant.

Size of Family Unit Annual Family Income (does not exceed)

1 $21,257 2 $28,694 3 $36,131 4 $43,568 5 $51,005 6 $58,442 7 $65,879 8 $73,316

For family units with more than eight members, add $7,437 for each additional family member.

With respect to the application submitted by (son/daughter) ______________________, our annual family income meets the criteria mentioned above. Please allow him/her to apply for the Dual Credit Scholarship provided through the College Access Challenge Grant.

Student Signature: ____________________________________________ Date: ___________

Parent Signature: _____________________________________________ Date: ___________

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Accessing Your Student Accounts@ College of Western Idaho

Your User Name & Password are used to login to MyCWI, Blackboard, MyCWI email, student computers and the IT Help Desk. Your MyCWI account will be created approximately 48 hours after you are admitted as a student; Blackboard and email accounts will be created within about 24 hours of class registration.User name: First name + Last name; ex JohnDoeTemporary Password: First Initial Capitalized + Last Initial Capitalize + logon + last 4 of SSN; ex JDlogon1234

RESET YOUR TEMPORARY PASSWORD before you access any of your student accounts. There are three ways for students to change their passwords:

1) Visit logonhelp.cwidaho.cc and click the change password link.2) Logon to a student computer and follow the password change prompt.3) Logon to MyCWI (see below) and follow the password change prompt.

MyCWI will allow access to class registration, financial aid, unofficial transcripts, billing, program evaluations and much more. You can access MyCWI from mycwi.cc or from the Current Students webpage.

Blackboard is an online learning system used by instructors to post the course syllabus, lecture notes, grades, etc. Online courses will be accessed through Blackboard. You can access Blackboard from blackboard.cwidaho.cc, the Current Students webpage or through MyCWI.

MyCWI Email will be your primary means of communication from the college and your instructors. You can access MyCWI email from cwidaho.cc/information-technology/email.php, the Current Students webpage or through MyCWI.MyCWI email: First name + Last [email protected];

ex. [email protected]

Student Computers may be used in any of the CWI computer labs, a great place to do your homework or receive FREE tutoring!

IT HELP DESK can be used if you are having issues with your student accounts or technology on campus. Submit a help request online at helprequest.cwidaho.cc, by email at [email protected] or for urgent issues please call 562-3444.

Login using your MyCWI email address & password

Information Technology Help Deskhelprequest.cwidaho.cc or 562.3444

Earn College Credit in High School

Double the Credit, without Doubling Time or Money!

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Grades Dual credit students are held to the same course content standards and standards of achievement as those expected of students in post-secondary courses. Dual credit students are assessed using the same methods (e.g. papers, portfolios, quizzes, labs, etc.) as their on-campus counterparts. Postsecondary courses administered through the Dual Credit program reflect the pedagogical, theoretical, and philosophical orientation of the sponsoring faculty and/or academic department at CWI. Any grade appeals follow the policies described in the CWI Cata-log. Students may view their grades through the myCWI student por-tal. If you are receiving high school credit your school may require an official transcript as record of your grade and credit hours. Without a Dual Credit Permission to Release Education Record form on file, theinsti-tution will not release academic information to parents. Please be aware that your grade does go on your permanent academic tran-script.

Drop and Withdrawal Procedures Dual credit students can only drop/withdraw from courses by sub-mitting an Add/Drop form directly to the CWI Dual Credit Office. Being dropped from a course for non-payment is not a guarantee nor the responsiblity of the College of Western Idaho, and will not replace the student's responsibility to submit an Add/Drop form. Students taking Dual Credit courses at a high school campus will have different drop and withdrawal deadlines than course taken on campus or online. Please review the included CWI Student Checklist for addi-tional information. Deadlines are published in the official academic calendar each semester for on campus and online courses and within this packet for courses offered at high schools. Students dropping courses prior to the drop deadline are entitled to 100 percent refunds of tuition and fees. A dropped course does not generate a permanent academic record. All class drops must be officially recorded by the College by completing an Add/Drop form and submitting it to the Dual Credit Office. Classes may NOT be dropped by telephone or e-mail. Failing to drop by this method may result in an outstanding debt to the College as well as a permanent academic transcript record with a grade of “F”. Once the drop deadline has passed, students may with-draw from courses or completely withdraw from all courses taken on campus or online that are a full semester in length through Friday of the twelfth week of class for fall and spring semesters or Friday of the sixth week of class for the summer semester; courses offered at the high school will have until the withdrawal deadline provided in this packet. A withdrawn course generates a permanent academic tran-script record with a grade of "W". This is considered an unsuccessful attempt and can have impact on a student’s financial aid eligibility. Students who withdraw from courses after the census date are NOT entitled to refunds and the full balance owed remains due and payable to CWI.

Payment Policies 1. Students will be charged the $65 per credit tuition rate as estab-

lished by the State Board of Education Council on AcademicAffairs and Programs (CAAP) plus any additional online or lab fees associated with the courses for which they enroll.

2. Books and materials are the responsibility of the student.3. Students who do not make payment in full by the appropriate

deadline will be charged a $50 late fee and may be dropped fromcourses for nonpayment. Please review the included StudentChecklist for additional information on these dates.

4. Payment may be made online via myCWI, at the CWI Dual CreditOffice, or at any of the CWI One Stop Student Services locations.

5. Students, and their cosigner if required, will be bound by the “Dual Credit Payment Agreement” that appears on the back page of the Dual Credit Registration Form included in this packet.

Official Transcripts CWI official transcripts can be ordered online at www.studentclearinghouse.org. Please make sure to request these transcripts from the College of Southern Idaho as CWI delivers college credit instruction through its’ memorandum of understanding with CSI.

Dual Credit Staff and Contact Information

Kathy Culbertson Dual Credit Administrative Assistant

Office: (208) 562-3371 [email protected]

Shannon Pape Dual Credit Coordinator Office: (208) 562-3224

[email protected]

Jacque Deahl College Readiness Coordinator

Office: (208) 562-3172 [email protected]

Dr. Eric Studebaker Director of Dual Enrollment

In-person, deliver forms to:

CWI Dual Credit Office 5500 East Opportunity Drive

NCAB Room 107 Nampa, Idaho 83687

Mailed forms should be sent to:

CWI Dual Credit MS 2000

PO Box 3010 Nampa, Idaho 83653

http://www.studentclearinghouse.org

Documents

Dual Credit Registration Packet