Community College Dual Credit Partnership Form

Dual Credit Quality Act (DCQA)

Request for Partnership Agreements

Please use this form to submit all executed or amended dual credit partnership agreements in effect since June 30, 2025, per the Dual Credit Quality Act P.A. 104-0012 (110 ILCS 27).

If you are submitting an amendment, please include the original executed partnership agreement.

Note: if you experience technical difficulties, please email ICCB.DualCredit@illinois.gov.
Name of College*
Community College Contact Information
Name*

First NameLast Name
Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
School District Liaison Contact Information
School District:*
Name*

First NameLast Name
Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

For every high school district you are uploading a partnership form for, please enter contact information below. *

	High School	First Name	Last Name	Email	Phone Number
High School 1
High School 2
High School 3
High School 4
High School 5
High School 6
High School 7
High School 8
High School 9
High School 10
High School 11
High School 12
High School 13
High School 14
High School 15
High School 16
High School 17
High School 18
High School 19
High School 20
High School 21
High School 22
High School 23
High School 24
High School 25

Please use the space below to share any information you would like ICCB to know regarding your institution's Community College Dual Credit Partnership(s).*

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Upload your institution's Community College Dual Credit Partnership Agreement(s) in PDF form below. Please note, you may upload up to 25 files. If you have more than 25 partnership agreements to submit, please combine the files before submission.*

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Please enter the email of the person who is responding to this form below. This email will be used to send you a copy of your response as confirmation of submission.*
example@example.com
Thank you for filling out the form. When required questions are completed, press "Submit" at the bottom of the form.
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