2016-2017 Home School Dual Credit Parent Verification/Authorization Form

  • Section I Student Information

  • Section II Score Verification

  • Enter available scores: (Failure to provide prerequisite test score verification may result in removal from course.)
  • ACT Subscores

  • SAT Subscores

  • COMPASS/KYOTE Placement Scores

  • AP Subject

  • CLEP Subject

  • Section III Parent (Guardian Acknowledgement

  • As Parent or Legal Guardian of _ (student’s name), I agree that I am responsible for the payment of any tuition, textbooks, parking permits, and fees associated with _ (student’s name) participation in the Kentucky State University Dual Credit Program. Furthermore, full payment of tuition will still be required if (student’s name) fails to withdraw from a course prior the last day to add/change registration (see below).
  • The completed Parent Verification/Authorization Form is due each semester no later than one week after classes begin. Failure to return the form in time may result in a student being withdrawn from their courses. Fall 2016 August 20: Classes begin August 26: Last day to add/change registration for a refund

All home-school students participating in Kentucky State University’s Dual Credit program must have their parent or guardian sign, complete and return the Dual Credit Home-School Parent Verification Form. This form is due no later than 4 pm on August 12, 2016.