Permission to attend PCC classes

Web services

To be completed by an education official only (i.e., student’s school counselor, administrator, education service district employee)

"*" indicates required fields

Student's information

Student's name*

First Last

Student's date of birth*

Student's PCC ID number

Education official's information

Please check one of the following*

High School Students: By checking this box, I verify that I am an authorized educational official who is able to allow permission for the above named student to attend Portland Community College and to take courses to meet high school graduation and/or get a head start on college coursework. I have spoken with and advised the student and/or parent/guardians on school and district requirements and I approve of their enrollment. The student understands that courses taken will be a permanent part of their academic record which may impact eligibility for future financial aid, scholarships, athletic team eligibility, and transferring to another college/university. Additionally, unless arrangements have been made by our high school/district, the student understands that they will be responsible for payment of tuition, fees and books for courses and for providing their own transportation. I may be contacted in the future with questions on the student’s eligibility or educational records.

Home School Students: By checking this box, I verify that I am an authorized educational official who is able to confirm that we have received the above named student’s Notification of Intent to Home School and I verify that they are officially registered with our Educational Service District. Information regarding statewide testing requirements and other home school matters can be found at the Oregon Department of Education’s website. The student understands that courses taken will be a permanent part of their academic record which may impact eligibility for future financial aid, scholarships, athletic team eligibility, and transferring to another college/university. Additionally, unless arrangements have been made by our high school/district, the student understands that they will be responsible for payment of tuition, fees and books for courses and for providing their own transportation. I may be contacted in the future with questions on the student’s eligibility or educational records.

Release or exemption from compulsory education for high school and home school students 17 years of age and under.

Education official’s name*

First Last

Name of education official’s institution or service district*

Education official’s work email*

(note: must be from a work email, i.e., ends in .edu, .org, or .k12.or.us)

Education official’s work phone number*

Specific course recommendations

(note: course prerequisites and placement requirements still apply)

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Comments

This field is for validation purposes and should be left unchanged.