Student Name:_______________________________________________________________
	Last Name	First Name
Address:    __________________________________________________________________
Social Security Number: ________________		Present Year in School: _____________
(This will be used as the student's I.D. number)		(If for summer semester, please list the year in school for the upcoming school year.)

The above mentioned student has my permission to take the coursework listed below at Danville Area Community College for the _______________ semester. This coursework is to be designated as:

____________ Dual Enrollment Coursework (credit will be granted for the high school and college.)
____________ High School Credit Only
____________ College Credit Only

I recommend that the student be admitted following the required (if any) DACC placement assessment. The student's current high school grade point average is a _________ on a _________ scale.

Recommended Coursework: Please list specific courses, approved maximum credit hours, or approved maximum number of courses.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Important Notes:

• Students must complete a DACC application.
• Tuition for Dual Enrollment coursework will be waived for students attending an Illinois High school. Course fees may or may not be required depending on course and where it is taught.
• Developmental Courses are DEVE 098 & 099, DEVR 098 & 099, DEVM 098, 099, 100; MATH 101, MATT 132, and GSCI 100 CANNOT be completed for Dual Enrollment.
• Students are responsible for the course textbooks.