Dual Credit Student Registration

Please be aware you must fill out a separate registration for each semester.

1. First Name
2. Middle Initial
3. Last Name
4. Address
5. City
6. State
7. Zip Code
8. Birthdate (MM/DD/YYYY)
9. Phone Number
10. Grade Level
11. Student Email
12. SVCC ID Ex. @99887766
13. Term Choose TermSpring 2024
14. High School/Counselor Michael KoltonJodie HerwigAimee StollerSteve HodsonAmy EbertPaula DurbandBeth MorseDave BaisdenMegan FacioStacey BontzJennifer StreetsDebbi KellyKatrina GraffJim TurffsJulie SandersIda HolperAngela GlassburnJason SandsKennidy SummersJeffrey GaleChristine HerronDarci FrancisAlexandra MillerPam MedemaDakota GeeseyJohn KotmanMissy HartmanTest - Geoff BorkDevon Plachno
15. Parent/Guardian E-mail Address
16. 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)
17. 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)
18. Electronic Signature