Dual Enrollment Student & Parent Agreement

Office of School & College Partnerships

Email: dualcredit@brazosport.edu Phone: 979-230-3633
Dual Enrollment Student & Parent Agreement
Student Information
Full Name*

First NameLast Name
BC ID#*
*Must be 9 digits
Date of Birth*

MonthDayYear
Personal Email *
(Do not use high school email)
Cell Phone*
Please enter a valid phone number.
HS Grad Date*
MM/YYYY
Grade Level*
*Summer & Fall- grade you are going into / *Spring- grade you are currently in
High School*
Student Signature
As the above-mentioned student, am stating that I have read and agree with all conditions and requirements of enrollment and registration outlined above. I agree to abide by all applicable college policies and rules.*

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Parent/Legal Guardian Information
Full Name*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Personal Email*
example@example.com
Relationship to student*
I certify that I am the parent or legal guardian of the above-named student and I have read and understand the above statements and agree to terms and stipulations.
- I understand that when a student attending postsecondary education - at any age - the rights under the Family Educational Rights and Privacy Act (FERPA) transfer to the student for college education records and - unless an exception applies - I will not have access to my student's records. I understand, even if the student is under 18, I must have my student's written permission or proof that I claimed the student as a dependent on my most recent income tax return presented to the BC Registrar's Office.
- I understand the student may be exposed to adult material in the classroom and open laboratories, including libraries, learning centers and computers labs.
- I understand the student will be responsible for any chanrges remaining on their account not covered by any applicable ISD sponsorship and/or tuition & fee waiver.
Parent/Legal Guardian Signature
I, as a parent/legal guardian for the above-mentioned student, am stating that I have read and agree with all conditions and requirements of enrollment and registration outlined above. I understand that this permission will remain in effect until the student has graduated from high school or it is rescinded in writing. I give permission for the above-mentioned student to enroll in Brazosport College's Dual Enrollment program.*

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Office of School & College Partnerships

Dual Enrollment Student & Parent Agreement

Student Information

Student Signature

Parent/Legal Guardian Information

Parent/Legal Guardian Signature