Grace Christian Dual Enrollment Registration Application for Admission as a Dual Enrolled Student Application for Admission as a Dual Enrolled Student A Dual Enrolled student is a student who is currently in high school and wishes to take classes at Grace Christian University for high school and college credit. If a dual enrolled student wishes to enroll after high school to pursue a degree with Grace Christian University, a formal application must be completed and the student accepted as a degree seeking student. If you are human, leave this field blank. Personal Information Last Name * First Name * Middle Initial Suffix Address * City * State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip * SSN Enter your United States Social Security Number (if one has been assigned). Providing a Social Security Number is voluntary, however, it will assist us in matching test scores and transcripts with your admission application and facilitate the administrative process if you are admitted. Financial support is required to provide a valid United States Social Security Number prior to receiving stipends. This information will be used only as a highly confidential, personal identifier for statutory reporting purposes. If you do not have a valid Social Security Number or do not wish to report it, please leave this field blank. Entering an invalid number will delay your application processing. Birthdate * (MM/DD/YYYY) Ethnicity American Indian or Alaskan Native Asian Black/Non-Hispanic Origin White/Non-Hispanic Origin Hispanic/Latino Native Hawaiian or Pacific Islander Multiracial/Parent of different races Gender * Male Female Marital Status * Single Married Name of Home Church What are the main factors in your decision to dual enroll at Grace Christian University? Contact Information Primary Phone * May we text? Yes No Preferred Phone Number * Home Cell Email * please use high school email Where do you plan to take your dual enrollment class? High School * Tri-Unity Potter's House North Pointe Christian Calvin Christian Grace On-Campus Grace Online South Christian Other Year of Graduation * 2030 2029 2028 2027 2026 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 New Option New Option New Option New Option Have you taken any previous college classes, Advanced Placement (AP), or CLEP tests? If yes, please list. * Yes No Parental Information Parent/Guardian Title Last Name * First Name * Middle Address * City * State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip * Phone * Email address * Has attended Grace Christian University? Yes No Years * 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 Maiden/Previous Name Signature(s) Statement of Financial Responsibilities: All classes for Dual Enrollment must be paid in full prior to classes being taken. If you are taking classes through your high school, your school will provide you with the necessary documents. Payment plans are available for those taking classes on campus. Please contact our Business Office to make arrangements. If payment is being made by the State of Michigan, proper documents of dual enrollment eligibility need to be on file prior to the start of class. If documents are not on file and payment cannot be received from the State, then the payment for the class(es) will be the responsibility of the student and their parent(s). Student Signature * Clear Date * Parent Signature * Clear Date * Submit
