Common Contracts

Dual Enrollment Program Agreement

Student and Parent Agreement • April 20th, 2017

• Contract Type
  Student and Parent Agreement
• Filed
  April 20th, 2017

Last Name (Print legal name in full) Suffix ( Jr., Sr., II, etc.) First Name Middle Previous Name(s) Mailing Address: Street Address or PO Box City State Zip Code Country Permanent Mailing Address: Street Address or PO Box City State Zip Code Country E-Mail: Home Phone #( ) Cell Phone #( ) Campus preference for Advising and Student Services: Main/tfort Pierce  Chastain/Stuart Pruitt/St. Lucie West  Dixon Hendry/Okeechobee  Mueller/Vero Beach Date of Birth: MM/DD/YYYY / /  High School Name/Home School City: State: Graduation Month/Year:  Home School students must also provide a verification letter from their county school board office confirming their enrollment in an approved home school program (FS 1002.41).