2025-2026 Online Dual Enrollment Form

Columbia College Dual Enrollment Form
Student Name*

First NameLast Name
Student ID (W#)*
Complete the one-time application here: https://www.opencccapply.net/gateway/apply?cccMisCode=591
This form, or its printable version, is required prior to registration for all high school students, as well as younger students with special approval. A completed Columbia College application and a Student ID (W#) are necessary before this form can be processed.

Completion of this form acknowledges that:

The student will be considered a dual enrollment student enrolled in Columbia College courses.
Students must follow the student code of conduct.
Students are expected to act with maturity in their coursework.
By taking college classes, students are creating an official college transcript.
Students must be in good standing at their high school and should talk with a high school or college counselor to choose the right classes. Failing a college course (receiving an F) can affect future college enrollment and financial aid, so it’s important for students to ask for help if they need it.

Unit Limits and Tuition

Dual Enrollment students may take up to 11 units per semester, or up to 15 units if they are enrolled in a CCAP college course at their high school campus.
If a student enrolls in more than the allowed units, they will be charged full tuition and fees for that semester.
For questions, call (209) 588-2176 or email ccdualenrollment@yosemite.edu.
Access to College Services

Dual Enrollment students have access to free services at Columbia College, including:
Academic counseling
Online and in-person tutoring
Mental health counseling
Additional student resources
By signing this form, both the student and parent/guardian acknowledge that the student can use these services. It is the student’s choice which services they use.
Students with disabilities or in need of accommodations should contact Disability Services at (209) 588-5130.
By completing and signing this form, all parties acknowledge the following as part of the agreement.
Phone Number
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Current Grade Level

FreshmanSophomoreJuniorSeniorOther
Parent/Guardian Email*
example@example.com
School counselor/representative to send to: email (to sign)*
example@example.com
High School
If not listed, put "Other"
In case of error, copy School Representative email from above:
example@example.com
Other: School Name
In case of error, copy School Representative email from above:
example@example.com
Send to Bret Harte
Send to Summerville
Send to Sonora
Multiple Email - Should show parent and school emails from above
Please double check for accuracy or form will need to be resubmitted
By signing this form, the student acknowledges the following:
I understand if I take more than 11 units that I will be responsible for all tuition and fees. If in at least one CCAP course (college course on high school campus), I acknowledge that I will take no more than 15 units or 4 courses.
By signing this form, I agree to:*
Student Signature*

Clear

Parent Agreement
Parent/Guardian Name

First NameLast Name
Emergency Contact Information
By signing, the parent/guardian agrees this student can enroll in college courses before graduating High School. You also acknowledge certain information may not be shared due to FERPA but that your child can grant this permission or share any information they willingly choose to. Parent/guardian recognizes medical treatment or personal counseling services cannot be refused by the staff of Columbia College Health Services if the student requests these services on the Columbia College campus, or virtually.

If student requires DSPS accomodations, please reach out to 2095885130

Please email ccdualenrollment@yosemite.edu if you wish to revoke this parental authorization at any time.
Parent Signature*

Clear

School Agreement
High school principal or authorized designee – by signing below you acknowledge the following:

ONE YEAR APPROVAL: I have reviewed the academic record of the above-named student and certify that the student demonstrates adequate preparation and may benefit from advanced scholastic education. (Ed Code 48800(a)) I support this student enrolling in up to 11 units (15 units for CCAP), not to exceed 4 courses per semester. I understand this approval will allow the student to enroll in Columbia College courses for the duration of the academic year and that the college cannot limit enrollment into select classes.
SUMMER ONLY: I certify that I am limiting the number of recommendations to no more than five percent of the total number of students who completed the grade immediately prior to the time of the recommendation for summer session. (Ed Code 48800 (d))

STUDENTS WITH DISABILITIES: I understand the high school is responsible to fulfill all accommodations outlined in a student’s IEP or 504 plan in accordance with Free Appropriate Public Education (FAPE) and Individuals with Disabilities Education Act (IDEA). I agree to notify the IEP/504 Coordinator from my school of this student’s intent to enroll in college so that they can arrange for continuation of disability services at Columbia College.
Please check this box if the student is in an Early College Program and you grant approval for dual enrollment for the duration of the program.
School Signature*

Clear

Submit
Should be Empty:

Columbia College Dual Enrollment Form

I understand if I take more than 11 units that I will be responsible for all tuition and fees. If in at least one CCAP course (college course on high school campus), I acknowledge that I will take no more than 15 units or 4 courses.