High School Student Parent/Guardian Approval Form 07/06/2022

First Name  Last Name  

Last 4 of SSN   Richland Student ID Number  

Name of High School Argenta-Oreana High SchoolCerro Gordo CUSD #100Clinton High SchoolDecatur Christian SchoolDistrict 21 Central A and MEisenhower High SchoolLutheran School AssociationMacArthur High SchoolMaroa-Forsyth High SchoolMeridian High SchoolMt Zion School DistrictSangamon Valley High SchoolSt Teresa High SchoolHome SchoolWarrensburg-Latham High School

Student Email

 I understand:

• This is not a registration form, additional registration information will be forthcoming.
• If my son/daughter plans to attend another college or university after high school graduation, I should check with that school to be sure the credits he/she will be earning in this program will transfer appropriately.
• Students participating in Richland courses will be evaluated as college students and are expected to follow the rules and regulations of Richland Community College. All students will abide by Richland’s Student Rights and Responsibilities as found in the Student Handbook.
• Richland Community College students are covered under the “Family Educational Rights and Privacy Act” (FERPA), which prohibits Richland Community College from disclosing information to anyone, including parents, without the student’s written consent.
• Course grades and attendance records will be released to the high school for purposes of awarding high school credit.
• If a student does not complete required coursework, an “Incomplete” may be assigned by the instructor. A student has 60 days from the end of class to resolve the incomplete grade. It is the student’s responsibility to remove the “I” so it can be replaced with the appropriate letter grade. When the “I” grade is replaced with the student’s letter grade, another grade report will be sent to the high school (dual credit only).
• Some material presented is for mature audiences.

         Parent/Guardian Information

Enter the initials  of the Parent/Guardian providing consent.  

Name

Address

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Phone

Email

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