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mji.edu  Academic Departments  High School  Course Authorization B
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DUAL ENROLLMENT COURSE AUTHORIZATION (B)

This form is to be completed and verified by the high school principal, guidance counselor or other relevant high school representative.  The form must be completed each time a class is requested from MJI. 

For students not taking classes under the Dual Enrollment Act complete this form.  For students taking classes under the Dual Enrollment Act please use the form titled Course Authorization A.

STUDENT INFORMATION

Student First Name   
Student Last Name  
High School Grade  
Counselor Name   
Counselor Phone Number   
Course Requested   
Semester   
   


STUDENT ACADEMIC INFORMATION

I certify that the course chosen is an appropriate academic option for the above named student and that this student is capable of performing the college level academic work required for this class.  Also, it is my understanding that tuition and all other expenses appropriate to this course will be paid by the student and/or their parent/guardian. 

Please select one of the following options:

I certify that the student needs this class to graduate and will be receiving both high school and college credit for this class

I certify that the student does not need this class to graduate and is enrolling in the course in addition to his/her high school class schedule. The student may or may not be receiving college credit for the course.

Name of School  
Name of School District  
Name of School Official  
In lieu of signature, last 4 digits of SSN of School Official    

MJI Invoice should be sent to the following:

Name  
Address  

 

For MJI scholarship information, please contact:  dualenrollment@mji.edu

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