01_CA/PA_Summer ONLY (Summer 2026)

Time remaining in this session. When it reaches 0, unsaved work will be lost.

--:--

* = required field

Some content may be updated based on selection

Dual Enrollment Office

COURSE APPROVAL FORM

Summer 2026

Summer 2026 TUITION ACKNOWLEDGMENT

Due to the increased enrollment in Fall 2025 and Spring 2026, there are NO DUAL ENROLLMENT SCHOLARHIPS for the Summer 2026 semester. Please READ CAREFULLY and acknowledge the statements below before proceeding.

I am responsible for paying the FULL tutition for the courses I am requesting on this form.

Tuition for Summer 2026 is $184 per credit hour.

3-credit hour class = $552

4-credit hour class = $736

I understand that I am automatically enrolled in the Pioneer Pack textbook rental program when I am registered for classes. If I do not opt out of the program, I will be charged an additional $25 per credit hour to cover textbook rental for my class(es).

3-credit hour class = $75 added to tuition

4-credit hour class = $100 added to tuition

Student Information (MUST match the information on your Jefferson State Application)

First Name:

Last Name:

E-mail:

Date of Birth:

(MM/DD/YYYY)

A-number:

(If known)

High School and Term Information

High School:

Grade Completing In May 2026:

Summer 2026 Course Requests

Online or JSCC Campus Course 1

Course Subject

Course Number

Campus

Would you like to add an additional course to your Summer schedule?

Yes

Online or JSCC Campus Course 2

Course Subject

Course Number

Campus

Would you like to add an additional course to your Summer schedule?

Yes

Online or JSCC Campus Course 3

Course Subject

Course Number

Campus

Would you like to add an additional course to your Summer schedule?

Yes

Online or JSCC Campus Course 4

Course Subject

Course Number

Campus

Would you like to add an additional course to your Summer schedule?

Yes

Online or JSCC Campus Course 5

Course Subject

Course Number

Campus

Important Information Regarding Dual Enrollment Participation

Check each statement to indicate that you have read and understand the information presented.

Release of Records to the Secondary Institution

Check the statement to indicate that you have read and understand the information presented.

As a participant in the Dual Enrollment for Dual Credit program, I understand that it is the responsibility of Jefferson State Community College to release my academic information to my high school and/or secondary educational entity. In signing this form, I authorize the College to release the information noted in this section.

It is the policy of the Alabama Community College System and Jefferson State Community College, a postsecondary institution under its control, that no person shall, on the grounds of race, color, disability, sex, religion, creed, national origin, age, ethnicity, genetic information, marital status, veteran status, pregnancy, sexual orientation, or gender identity/expression be excluded from participation in, be denied benefit of, or be subjected to discrimination under any program, activity, or employment.

Please wait for files to finish uploading