Chandler-Gilbert | Estrella Mountain | GateWay | Glendale | Mesa | Paradise Valley | Phoenix | Rio Salado | Scottsdale | South Mountain

Next Steps
Dual Enrollment for Fall 2023 is now closed. Submission of this form does not guarantee enrollment for the Fall 2023 Dual
Enrollment semester and processing of submitted documentation will be handled by each college on an individual basis. Submitting
this form does not mean a student will be enrolled for the Fall 2023 semester. If you have concerns or questions, please contact
your specific college. Spring 2024 Dual Enrollment registration will open later in October.

Please gather the following items to help you complete the Dual Enrollment process:

• Acceptable Forms of Identification (example: High School ID with Birth Certificate, AZ Driver License or State Identification, etc.)
• Documentation to Determine Course Placement (example: High School Transcripts (Juniors and Seniors only), SAT/ACT Scores, etc.)
• Please make sure a parent or legal guardian is present when completing financial responsibility and consent

Step One: Submit your Photo ID

Maricopa Community Colleges require students to submit a valid form of identification for authentication. This allows our colleges to confirm
your identity and prevent identity theft. You can submit online now or in-person at your college location with our Admissions, Records, and
Registration Offices.

Student Information

Primary College  Enrollment

* Estrella Mountain Community College Term * Spring 2024 

First Name * Kade Last Name * Carroll

Student ID * 37077873 Date of Birth * 2007-08-30

MEID * KAD2162263 Contact Phone * 623/694-4405

Maricopa Email * [email protected] Personal Email [email protected]

High School * Estrella Foothills High School 

Please upload Acceptable Forms of Identification from the list below: List includes High School ID Card and US Birth Certificate, US
Passport/Passport Card, or Arizona Drivers License, Instruction Permit, or ID Card

*Click here to see a complete list of acceptable IDs for identification authentication, as well as lawful presence and testing.

Identification Type: * High School ID 

*To qualify for in-state tuition you will need to submt additional documentation, such as your U.S. issued birth certificate.

UPLOAD AND ATTACH your documentation files here: * Screenshot 2023-11-13 095257.png

UPLOAD AND ATTACH your documentation files here: Screenshot 2023-11-13 095257.png

Helpful Hints

• Please use a scanner or digital camera (such as a phone camera) to create a color file of your documentation.
• Acceptable file formats are .jpeg, .jpg, .pdf, or .png.

Important Note:
The identification document must be in color and may may be rejected if the image does not meet requirements. We have the right to refuse any
document or ask for additional documentation.

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Step Two: College Readiness and Course Placement

According to Arizona State Law (ARS §§15-1805.01), students under the age of 18 must provide proof of college readiness to
take a college level course. Depending upon the student’s grade level, the documentation provided for college readiness
may also be used for placement into the desired course(s).
(Note: additional documentation may be needed to place into the college course desired to meet the prerequisites)

For more information review the high school's class list offerings.

Grade 9: the student must take appropriate assessment tests to prove college readiness and course placement as follows:

• For courses with no prerequisites, the EdReady Reading placement assessment test may be required to prove
college readiness
• For courses with prerequisites, refer to the class list offerings for the appropriate placement assessment tests
required

Grade 10: one of the following must be provided to prove college readiness.

• High School ACT Aspire ELA Score of Ready or Exceeds

• High School PSAT, SAT score of 720 or higher, or a Composite ACT score of 12
• EdReady Reading placement assessment test

Grades 11 or 12: one of the following must be provided to prove college readiness.

• High School ACT Aspire ELA Score of Ready or Exceeds

• High School PSAT, SAT score of 720 or higher, or a Composite ACT score of 12
• Unofficial high school transcript, the unweighted, cumulative GPA must be 2.6 or higher.
• EdReady Reading placement assessment test - other placement assessments may be needed for courses with
prerequisites

Select your high school grade level to see your options?

* Sophomore (10) 

Expected high school graduation date: * 05/20/2026

Estrella Mountain Community College High School Course Offerings

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g Option 1: High School ACT Aspire ELA Score of Ready or Exceeds
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g Option 2: High School PSAT, SAT score of 720 or higher, or Composite ACT score of 12 or higher
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g Option 3: EdReady Reading assessment placement test. The EdReady Reading placement test is a non-
proctored, online testing option that can be accessed at maricopa.edready.org.

Important Note:
Information submitted through this form will be used for course placement only. To satisfy other requirements for Admissions or Financial
Aid, please send a final, official transcript to the Admissions and Records Office.

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 Chandler-Gilbert | Estrella Mountain | GateWay | Glendale | Mesa | Paradise Valley | Phoenix | Rio Salado | Scottsdale | South Mountain

Step Three: Student Consent Form

This form is for all students under the age of 18. Students under 18 years old must have consent from a parent/guardian to
enroll at the Maricopa Community College in credit, clock hour, or non-credit courses. This form is proof of and fulfills the
following requirements: student information release, registration by proxy, financial responsibility, and for text
messaging/automated communication. Consent is valid until rescinded by the parent/guardian, or the student fully
matriculates, or until the student turns age of 18. Legally required notification with opt out provisions will still be sent.

FERPA Information Release Authorization

I, the student, agree to the exchange of academic information between the participating institutions, including but not limited to
college grade reports, transcripts, and other pertinent documents. I, the student, give permission to release Maricopa
Community College student information to my parent/guardian to be named in accordance with Federal Law. This does not
disturb the annual notifications with opt out provisions from occurring through standard notification practices.

FERPA Information Release Consent * Yes 

Registration Consent
Students under the age of 18 who are unable to register on their own may have a parent/guardian register for them "by
proxy." However, in order to comply with federal laws with the confidentiality of official student records (Family Education
Rights and Privacy Act of 1974), a release must be granted to authorize Registration by Proxy. I consent to the
parent/guardian to be named to initiate enrollment actions on my behalf.

Registration by Proxy Consent * Yes 

Create a PIN
Please enter a 4 digit security pin number. You will need to provide your FERPA PIN when seeking service or information
from your student account by a staff member.

The student can now authorize third parties (such as parents, guardians, or others) to have access to specific student
information in their Student Center. Once the student has authorized the third party in the Student Center, they can share
their FERPA PIN with the authorized third party to receive student account information from a Maricopa staff member.

Share this PIN with your parent/guardian to allow release of information from your educational records.

PIN Number * 0830

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Step Four: Parent/Legal Guardian Consent Form

Please make sure a parent or legal guardian is present when completing this form to consent to financial responsibility.

* Yes  I certify that I am the Parent/Legal Guardian submitting the form on behalf of the student?

Parent/Legal Guardian Information

First Name * Seth Last Name * Carroll

Relationship to Student * Father  Social Security Number

(Optional)
Phone Number * (602) 320-1769 Email Address [email protected]
Check this box if you do not have a email address g
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Address * 17588 W VERDIN RD

City * GOODYEAR State * AZ Zip * 85338

Consent to Call or Text

I give permission to Maricopa Community Colleges to contact the minor student via SMS text messaging and automated calls
or other methods of communication for official business to the phone number(s) on file in the student's account.

PLEASE NOTE:
All students are enrolled in the ALERT notification system in order to receive Emergency Alerts concerning health and safety
of people on campuses/sites via text message.

* No 

* g
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f As a parent or legal guardian, I give permission for the student to enroll in the course(s). I agree to notify the Dual
Enrollment Office at the college of choice regarding changes in enrollment, including dropping, adding, or changing
classes. Failure to pay may result in the the student being dropped from class(es) without notification.
* g
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f I understand that the student will be establishing a college academic record and will be required to report such enrollment
to future colleges or universities. He/she will be subject to the course requirements, grading standards and attendance
requirements established by the instructor in the course syllabus. I further understand that the student will be subject to
all of the requirements, policies, regulations, and deadlines defined in the College Catalog and Schedule of Classes.
* g
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f I (Parent/Legal Guardian) understand Section 2 - Financial Responsibility and I accept financial responsibility
for all tuition, fees, and fines that may be incurred related to my minor student’s enrollment in the Maricopa
Community Colleges.

• I understand that tuition and fees are added to a student account as a result of enrolling in classes.
• Once registered and enrolled, if not dropped by the 100% tuition refund deadline, I am responsible for all
tuition, fees, and fines charged to my minor student's account.
• Failure to attend class does not absolve me of the financial obligation as described above.
• Failure to resolve past due balances may result in impact of services, including holds on my minor student's
account restricting future registration, other services and forwarding of any unpaid past due balances to
collection agencies.

We expect the parent or legal guardian to check this box to consent.

* g
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f I approve the enrollment in any Maricopa Community College course until the student turns 18 years old. I also
acknowledge that I have read the Maricopa Tuition and Fees Policy (Section 2.2.9) and the Maricopa Refund Policy (Section
2.2.10).

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 Chandler-Gilbert | Estrella Mountain | GateWay | Glendale | Mesa | Paradise Valley | Phoenix | Rio Salado | Scottsdale | South Mountain

Step Five: Course Pre-Approval Form

Please include all course(s) into which you intend to register. You will receive notification to your Maricopa email address when you are approved
for self registration.

• Please allow 7-10 business days (Monday-Friday) to verify and review the Dual Enrollment Next Steps Form.
• Please check your email for instructions on how to self-register for classes.
• Check college course prerequisites to make sure you are eligible to self-register.

If you’re not sure what classes to take, contact your college dual enrollment office.

Estrella Mountain Community College High School Course Offerings

Term Course Class # Class Hour Instructor Credits

(select) (Ex. ENG 101) (Ex. 12345) (Ex. 1st Hour) (Last Name) (Ex. 3 or 4)

Spring 2024  * MAT 151 * 31908 2nd hour  * Nuebeck 4 

-- Choose -- 

To estimate the Total Amount Due = Total Credits x $97.00 (*In-state tuition) + $15 **Registration Fee

Important Note:
*To qualify for in-state tuition students must provide proof of lawful presence in the United States.
**A $15 registration fee is per college per term (semester) OR if registered for more than two Maricopa Colleges, you will pay $15 to each college,
per term.

Buckeye High School District

To estimate the Total Amount Due = Total Credits x $97.00 (*In-state tution) + $15 **Registration Fee
or
Occupational Classes: GBS151, ECH176 = Total Credits x $62.00 (*In-state tution) + $15 **Registration Fee

Important Note:
*To qualify for in-state tuition students must provide proof of lawful presence in the United States.
**A $15 registration fee is per college per term (semester) OR if registered for more than two Maricopa Colleges, you will pay $15 to each college,
per term.

I need to request courses at a second * No 

Maricopa College?

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Student Signature Electronically signed by Kade Carroll on 01/19/2024 10:05:59 AM

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