APPLICATION FOR DUAL ENROLLMENT/EARLY COLLEGE (386) 754-4300 phone or (386) 754-4800 Fax GATEWAY COLLEGE 149 S.E. COLLEGE PLACE LAKE CITY, FLORIDA 32025-2007

Welcome to ! We are excited that you are considering the Dual Enrollment Program (DE). The Dual Enrollment Program is designed to be an acceleration mechanism for students desiring to earn both high school and college credit. The program is an excellent vehicle for students to gain college credit and experience while simultaneously completing requirements for high school. It is not uncommon for the typical dual enrollment student to earn several college credits by the time he/she graduates from their high school or home education program.

To be considered for admission to the Dual Enrollment Program, the student must submit a completed Dual Enrollment application (with applicable test scores) while meeting the Florida Gateway College (FGC) admission application deadlines. Please check with your high school guidance counselor for specific information regarding admission application deadlines and/or see the College’s Academic Calendar (Critical Dates) publication on the college website http://www.fgc.edu.

Note: Students attending public high schools that are enrolled in this program will have tuition, books and fees waived. Students attending nonpublic high schools or home education programs that are enrolled in this program will have tuition and fees waived, however textbooks are the responsibility of the student.

APPLICATION PROCESS Please complete all sections of the Dual Enrollment Program application. Incomplete or unsigned applications cannot be processed.

A. Public High Schools/Nonpublic High Schools 1. Dual Enrollment participation must be initiated through the high school guidance office. 2. The DE application must have the student signature, the parent or guardian signature, the school principal or designee signature, and the required college entrance test scores (scores older than two years are not accepted). 3. Return the completed DE application to your high school guidance counselor. The application will need to be processed by the FGC Dual Enrollment office.

B. Home School Education Programs 1. Dual Enrollment participation must be initiated by the parent or guardian through the FGC Dual Enrollment office by providing proof that Home School Education meets Florida statutory guidelines from district school board. 2. The DE application must have the student signature, the parent or guardian signature, the school principal or designee signature, and the required college entrance test scores (scores older than two years are not accepted). 3. Make an appointment with the FGC Dual Enrollment office to submit the completed application and meet with the DE Advisor. Parent must execute the DE articulation agreement with FGC.

Should you have any questions, please contact your high school guidance counselor and/or the FGC Dual Enrollment Staff Assistant at (386) 754-4341. We look forward to seeing you on campus!

DUAL ENROLLMENT/EARLY ADMISSION APPLICATION FOR ADMISSION (386) 754-4300 (386) 754-4800 Fax

NOTIFICATION OF SOCIAL SECURITY NUMBER COLLECTION AND USE: In compliance with and pursuant to Florida Statute 119.071 (5), 1008.386, 1002.22(2), and SBE Rule 6A – 1.0955 (3) (e), Florida Gateway College (FGC) issues this notification regarding the purpose of the collection and use of your Social Security number. FGC collects your Social Security number for use in performance of the college’s duties and responsibilities. In a seamless K-20 educational system, it is beneficial for postsecondary institutions to have access to the same information for purposes of tracking and assisting students in the transition from one educational level to the next. Federal legislation relating to the Hope Tax Credit requires that all postsecondary institutions report the Social Security number of all post-secondary students to the Internal Revenue Service (IRS). This IRS requirement makes it necessary for colleges to collect the Social Security number of every student. A student may refuse to disclose his/her Social Security number to the college, but refusing to comply with the federal requirement may result in fines established by the IRS. Providing your SSN on this form signifies that you consent to the use of your number in the manner described. To protect your identity, FGC will secure your Social Security number from unauthorized access. FGC will never release your Social Security number to unauthorized parties, and each student at FGC will be issued a unique student identification number. Your unique student identification number is used for all educational purposes at FGC including registration, access of your online record, etc. All Social Security numbers are protected by federal regulations and are never released to unauthorized parties. For additional detailed information on the college’s collection and use of social security numbers, please visit the college’s website at https://www.fgc.edu/current-students/registrar/right -to-know/

GENERAL INFORMATION

1. Have you previously attended Florida Gateway College? YES NO

2. Social Security Number:

3. FGC ID #: (for Admissions Office use only)

4. Legal Name: Last First Middle

Preferred First Name:

5. Previous Name: Last First Middle

6. Permanent/Mailing Address: Street or P. O. Box City State/Zip County

7. Phone: Home Phone Cell Phone

8. Parent E-mail Address:

9. Emergency Contact Information: Name : Last First

Phone Relationship to Student

BIOGRAPHICAL/PERSONAL INFORMATION

Disclosure of information collected in items 10-13 is not mandatory, however it is requested to aid the State of Florida in its commitment to Equal Educational and Employment Opportunity and to meet federal reporting requirements. This data may also be used in the awarding of scholarships. It is not used discriminatively for admission purposes. Refusal to answer the information requested in items 10-13 will not result in the adverse treatment of any applicant.

10. Gender/Sex: Male Female

11. Date of Birth: Month Day Year

12. Citizenship: U.S. Citizen Resident Alien Card #/Expiration Date:

Other Please Specify:

13. A. Ethnicity: (check one): Hispanic or Latino Not Hispanic or Latino

B. Race: (check one or more): American Indian/Alaskan Native Asian

Black/African American Native Hawaiian/Pacific Islander White

Student name: FGC ID#: Term:

HIGH SCHOOL/FGC ENROLLMENT

14. High School: Grade you are in now:

15. Prior College Work/Attendance: Yes NO Month/Year of Anticipated Graduation:

If yes, name of institution

16. FGC Entry Term: FALL (August) (Yr.); SPRING (January) (Yr.);

SUMMER A (Yr.) SUMMER B (Yr.) SUMMER C (Yr.)

17. Enrollment Plans: / (Refer to FGC Dual Enrollment Programs of Study.) Program Name Program Code

18. Degree: (A.A., A.S., A.T.D., CER.)

APPLICATION AGREEMENT

We, student and parent (or guardian), agree to enroll in the Dual Enrollment/Early College Program at Florida Gateway College and certify the information on this application is accurate and complete. Based on the high school academic record and over-all maturity level of the student, we believe he/she will be successful in college level studies.

We agree to abide by the guidelines of the Dual Enrollment/Early College Program, as well as the College policies and procedures while attending FGC. We understand all college grades become a permanent part of the student’s college record and we agree to the College’s release of information concerning any awards or academic honors the student might receive.

Student Signature:

Parent/Guardian Signature*: Date: *Note: An “Authorization to Disclose Information” must be completed and submitted to the Registrar’s Office in order to have access to any student information. This form is located at: www.fgc.edu under Current Students/ Forms/ Authorization to Disclose Information.

Florida Gateway College is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools to award the baccalaureate and associate degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097, or call 404-679-4500 for questions about the accreditation of Florida Gateway College. The Commission is to be contacted only if there is evidence that appears to support an institution’s significant non-compliance with a requirement or standard. u FGC will adhere to all applicable federal, state, and local laws, regulations, and guidelines with respect to providing reasonable accommodations as required to afford equal educational opportunity. Students may obtain further assistance and information by calling Janice Irwin, coordinator of dis- ability services, at (386) 754-4215. The Disability Services Office is located in Building 017, Room 021, 149 SE College Place, Lake City, Florida 32025. u Florida Gateway College does not discriminate in education or employment related decisions on the basis of race, color, religion, national origin, gender, age, disability, marital status, genetic information, or any other legally protected status in accordance with the law. u The Equity Officer is Sharon Best, executive director of human resources, Building 001, Room 136, 149 SE College Place, Lake City, FL 32025, and may be reached at (386) 754-4313.

EXCESS HOURS ADVISORY STATEMENT Section 1009.286, Florida Statutes, establishes an “excess hour” surcharge for a student seeking baccalaureate degree at state universities. It is critical that students, including those entering institutions, are aware of the potential for additional course fees. For the 2012-13 academic year and thereafter, “excess hours” are defined as hours that go beyond 110% of the hours required for a baccalaureate degree program. For example, if the length of the program is 120 credit hours, the student may be subject to an excess hour surcharge for any credits attempted beyond 132 credit hours (110% x 120).

All students whose educational plan may include earning a bachelor’s degree should make every effort to enroll in and successfully complete those courses that are required for their intended major on their first attempt. Florida College System students intending to transfer to a state university should identify a major or “transfer program” early and, by the time the student earns 30 semester hours of college credit, be advised of admission requirements for that program, including the approved common prerequisites. Course withdrawals, and/ or repeats, as well as enrollment in courses nonessential to the intended major, may contribute to a potential excess hours surcharge.

Test Type High School GPA Assessment Record Test Date

English Score Test Date

(Sentence Skills)

SAT 1 (4/95 & Later) CPT ACT PERT Suggested Coursework **New SAT ENC 0015 Principles of Writing 1 20 – 54 Below 440 – (Old SAT1) 50 – 89 Below 17 – SLS 1501 The College Experience Below 25 – (**New SAT) Take PERT to determine prep level ENC 0025 Principles of Writing 2 55 – 82 Take PERT to determine prep or college level 90 – 102 SLS 1501 The College Experience 440 – 800 83 – 120 17 – 36 103 – 150 ENC 1101 Freshman Composition 1 * Or 26 or higher (New SAT) * STUDENTS MUST ALSO SCORE OUT OF PRINCIPLES OF WRITING 2 TO TAKE FRESHMAN COMPOSITION 1.

Math Score Test Date PERT

CPT SAT 1 (4/95 & Later) Path 1 – Path 2 – ACT Suggested Coursework Arithmetic El Algebra CL Math **New SAT STEM Liberal Arts Below 440 – (Old SAT1) MAT 0015 Arithmetic with Algebra 20 – 85 & 20 – 71 Below 19 – 50 – 95 50 – 95 Below 24 – (**New SAT) SLS 1501 The College Experience Take PERT to Take PERT to determine MAT 0025 Elementary Algebra 86 – 120 & 20 – 71 determine prep level 96 – 113 prep or college level SLS 1501 The College Experience MGF 1100 Quantitative Literacy – or 96 – 113 or MAT 1033 Intermediate Algebra (Take this if you 114 – 122 need MAC 1105 and MGF 1106 or 1107.) 440 – 490 or 72 – 82 19 – 20 114 – 122 MAT 1033 Intermediate Algebra 24 – 26 – (**New SAT) MGF 1106 Mathematics for Liberal Arts 1 500 or higher 114 – 150 83 – 120 & MGF 1107 Mathematics for Liberal Arts 2 21 or above or Above 26 – (**New 35 – 69 MAC 1105 College Algebra SAT) 123 – 150 STA 2023 Elementary Statistics MAC 1140 Pre-calculus 83 – 120 & Departmental MAC 1114 Trigonometry 70 – 102 Exam MAC 2233 Survey of Calculus

83 – 120 & Departmental MAC 2311 Calculus 1 103 – 120 Exam

Reading Score Test Date

SAT 1 (4/95 & Later) CPT ACT PERT Suggested Coursework **New SAT ENC 0015 Principles of Writing 1 20 – 59 Below 440 – (Old SAT1) 50 – 83 1 – 18 SLS 1501 The College Experience Below 24 – (**New SAT) Take PERT to determine prep level ENC 0025 Principles of Writing 2 60 – 82 Take PERT to determine prep or college level 84 – 105 SLS 1501 The College Experience 440 – 800 83 – 120 19 – 36 106 – 150 ENC 1101 Freshman Composition 1 * Or 25 or higher – (**New SAT) * STUDENTS MUST ALSO SCORE OUT OF PRINCIPLES OF READING 2 TO TAKE FRESHMAN COMPOSITION 1.

**Due to a different set of scoring criteria for the New SAT test (3/1/16 and later), this is a tentative Assessment Record. Once DOE determines the new college-ready threshold, a corrected/amended Assessment Record will be provided. May 2017 Rev.

PLEASE NOTE THE FOLLOWING: To continue enrolling in Dual Enrollment classes, students must maintain a Florida Gateway College GPA of 2.0 and a high school unweighted GPA of 3.0 to enroll in academic classes and a high school unweighted GPA of 2.0 to enroll in vocational classes. Florida Statute 1007.271 (3)

Regular Certification

The School Board of County has identified this student, , as qualified to participate in the Dual Enrollment/Early College Program in accordance with the Dual Enrollment Articulation Agreement.

School Principal or Designee Date

dual enrollment revised 5/2017