Dual Credit Student Registration

Student Registration Dual Credit - Only Register for Summer or Fall 2019 Classes

First Name
Middle Initial
Last Name
Address
City
State
Zip Code
Birthdate (MM/DD/YYYY)
Grade Level
Student Email
SVCC ID Ex. @99887766
High School/Counselor
Parent/Guardian E-mail Address
My electronic signature indicates that I give my consent and authorize Sauk Valley Community College to release my education records to my high school and to my Parent/Guardian (Please fill in Parent/Guardian)
If applicable I give my high school permission to release my IEP of information about accommodations through 504 to the Special Needs Coordinator at Sauk Valley Community College in order to arrange appropriate accommodations (Electronic Signature)
Electronic Signature

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