Spring High School Dual Enrollment Form

COURSE SELECTION

Please select the course(s) you wish to enroll in.

Please select your desired course(s) from the approved Dual Enrollment Course list. We cannot accommodate requests for courses not listed on the approved course list.

Course 1 CRN

Course 1 Lab CRN (only if course required)

Course 1 Recitation CRN (only if course required)

Course 2 CRN

Course 2 Lab CRN (only if course required)

Course 2 Recitation CRN (only if course required)

If you would like to register for additional courses, please contact the Undergraduate Admissions office.

TRANSCRIPT RELEASE

Please complete and submit the Millersville University Transcript Request Form to the Registrar's Office. This is necessary for your final grades to be released to you and/or your high school. Please submit this form immediately after applying for Dual Enrollment.

I provide consent to Millersville University to release my education records to my parents and current high school administrators, including scheduling information, transcripts/grade reports, and other academic records related to my status as a dual enrolled student. I understand this information will be released verbally and in written education records. I have the right to inspect any education records released. I understand I may revoke this consent at any time by contacting the Millersville University Registrar's Office.

Yes

ADDITIONAL INFORMATION

Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.

Yes

If yes - Please give the approximate date(s) of each incident, explain the circumstances and reflect on what you learned from the experience. You may use up to 400 words.

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony? Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

Yes

If yes - Please provide the details of your criminal conviction or adjudication and reflect on what you learned from the experience. You may use up to 400 words.