Dual Enrollment Form

The maroon and gold Central Michigan University action C logo.
This form must include your high school counselor/principal signature and should be submitted at least three weeks before your course start date. A new registration form must be submitted each semester that you dual enroll.

Type of High School *

* If other, please describe.

Grade Level *
Academic term used by your high school? *

Central Michigan University recognizes that a secure environment enhances learning opportunities. To provide the best possible learning environment, we require applicants to respond to the following statements, as part of the admissions process:

For reasons involving academic dishonesty, financial impropriety, or an offense that harmed or had potential to harm others, has any secondary school or college you have attended taken any of the following actions against you: expulsion, suspension, placed on a probationary period, other disciplinary action, or entered into an informal resolution resulting in disciplinary action with you? *
Have you ever been convicted of a criminal offense other than a minor traffic violation, or are there criminal charges pending against you at this time? *

COURSE SELECTION

Select term *
Select term
Select term

ALTERNATIVE SCHEDULE 
*optional - if courses above are unavailable

Select term

TUITION

It is the responsibility of the student to ensure this information is accurate and that their dual enrollment tuition is paid in full. If you drop/withdraw from a course, you may also be responsible for paying your school district back for their contribution.

Select a choice *

COURSE DROP OR WITHDRAW
*must be submitted prior to drop/withdrawal deadline

Select term

I certify all the information on this form is correct, and I agree to have information regarding my CMU dual enrollment (e.g., course schedule, final grade, etc.) shared with my high school.

* A copy of the submitted form will be emailed to you

 

THIS SECTION MUST BE COMPLETED BY HIGH SCHOOL COUNSELOR OR PRINCIPAL

* A copy of the submitted form will be emailed to you
* I certify that this student is in good academic standing and has our district’s approval to enroll in the above dual enrollment course(s) through CMU. I have confirmed that the tuition paid by the school district is accurate.

PLEASE COMPLETE THE FOLLOWING FOR SCHOOL CONTRIBUTIONS TOWARD DUAL ENROLLMENT TUITION:

* Please provide name, email & phone number
Will the school be paying for the cost of books/supplies (beyond the tuition contribution listed above)? *

 

Questions? We’re here to help!
Email dualenrollment@cmich.edu or call 989-774-4371.

Beaver Island Students: Contact Meri Kolemainen at kolem2ml@cmich.edu.