Student Application For College In High School (Page 3 of 3) in pdf

Student Application For College In High School Page 3

Student Application for College in High School (contd.)

High School: __________________________

____________________________________________

Teacher You Are Submitting Your Completed Application To: ________________________________________

Please indicate the course(s) you are registering for, the teacher, and please obtain the teacher’s initials. If you need to,

please get the specific course information from your teacher. Please use Pitt-Bradford Course names.

Course#1:

Teacher:

Teacher’s Initial:

Course#2:

Teacher:

Teacher’s Initial:

Course#3:

Teacher:

Teacher’s Initial:

Course#4:

Teacher:

Teacher’s Initial:

My son/daughter has my permission to enroll in the College in High School (CHS) course(s) indicated below for the

school year 2016-2017. I understand that the regular tuition for each course is $125.00 per 3 credit course, subject to the

issuance of a tuition reduction by the University of Pittsburgh – Bradford, in which case a rebate will be issued. The

tuition is non-refundable. I also understand that without a check or money order, my child cannot be registered in College

in High School. Students will receive University of Pittsburgh credit, which is transferable to other universities,

depending upon their transfer policies.

I have checked with son’s/daughter’s school and the established tuition amount per course for 2016-2017 is: $125.00

Tuition Remittance and Application Completion:

Tuition Amount:

# of Courses:

Total Tuition:

Signature of Parent

Date

Signature of Applicant

Date

Signature of CHS Teacher Collecting Your Application

Date

Student Application For College In High School Page 3