Commonwealth Dual Enrollment Pathways Program Form

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Commonwealth Dual Enrollment Pathways Program
Tidewater Community College’s dual-enrollment options provide qualifying high school and home school students a unique opportunity to jump-start their college careers.
Prior to completing the Commonwealth Dual Enrollment Pathways Program Form, students must complete the general online Application for Admission to Tidewater Community College (TCC) by clicking here.

Before you begin completing this dual enrollment application, please have your current cumulative grade point average accessible.
Student Name * Required
First Last
High School Email Address * Required
Personal Email Address * Required
Phone * Required
TCC Student/EMPLID * Required
You are assigned a TCC ID Number once you submit the general online Application for Admission. If you had already submitted an application to TCC in the past, use the ID number already assigned to you.
Date of Birth - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Date of anticipated high school graduation - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Are you currently under the age of 18? * Required
- Yes
- No
Are you attending a public high school?
- Yes
- No
How are you receiving your high school education? * Required
What high school are you currently attending? * Required

Virtual Virginia Dual Enrollment Pathways Program
What Dual Enrollment (DE) program are you interested in completing? * Required
- VCCS Passport (rising seniors)
- VCCS Uniform Certificate of General Studies (UCGS) (rising juniors)
- Career Studies Certificate in Cybersecurity & Network Foundations (rising juniors)
- Career Studies Certificate in Cybersecurity & Network Foundations (rising seniors)
- No Program - Individual Courses Only

Parent or Legal Guardian Signature for Applicants under the Age of 18

Tidewater Community College applicants under the age of 18 must provide their parent’s or legal guardian’s signature on the application for admission.
Last 4 Digits of Student's Social Security Number * Required
Parent/Guardian Name * Required
First Last
Parent/Guardian Signature * Required

Family Education Rights & Privacy Act (FERPA)

The Family Education Rights & Privacy Act (FERPA) of 1974 is a Federal law that protects the privacy of student educational records. The rights provided by this Act transfer from the parent to the son or daughter when the student reaches the age of 18 OR attends a postsecondary school — whichever comes first. Under this law, students have the following rights with regards to their educational records:
- The right to inspect and review their education records.
- The right to request an amendment to their education records when they believe the records are inaccurate or misleading.
- The right to consent to disclosures of personally identifiable information contained in their education records, except to the extent that FERPA authorizes disclosure without consent.
- The right to file a complaint with the United States Department of Education concerning alleged failures by the College to comply with FERPA.
While rights transfer from the parent to the son or daughter when the student reaches the age of 18 OR attends college, Virginia Law (Code of Virginia §23-9.2:3, amended July 2008), allows the parents of students who are defined as “dependent” under U.S. Tax Code access to certain records by providing evidence of tax dependency and making a specific written request.

Additional details regarding FERPA are accessible online at https://www.tcc.edu/about-tcc/statements-policies/ferpa/. Individuals with questions regarding FERPA may contact Nicole Wilson, of the TCC College Registrar’s Office, via email at nwwilson@tcc.edu. Information may also be obtained from any campus Enrollment Services Office or any dean for student services.

As permitted under FERPA, TCC will share your educational records with high school personnel and may address any questions or concerns with them regarding your performance.

STUDENTS AND PARENTS: ACKNOWLEDGEMENT
As high school student, I understand my rights under FERPA, and recognize that Tidewater Community College may share records with high school personnel as needed. My electronic signature below indicates that I understand and agree with the above statements. * Required
My son/daughter/legal dependent has my permission to apply to and participate in Tidewater Community College’s Dual Enrollment program. As part of this process, I acknowledge that he or she has completed an online Virginia Community College System (VCCS) application in addition to this application. I have reviewed the above FERPA information and understand my dependent’s rights under FERPA and know where I can get additional details regarding this Federal law. I recognize that additional information may be requested for admission and enrollment purposes. * Required
CONSENT TO RELEASE EDUCATIONAL RECORDS

Dual enrollment students who wish to authorize the release of their education records from a dual enrollment staff member to a parent/legal guardian and/or home school agent may do so via completion of applicable sections.*
Person(s) to whom you authorize the release of all education records, with continuous access permissible while a dual enrolled student (check and complete all that apply)**:
- Parent(s)/Legal Guardian(s)
- Home School Agent
- I do not authorize the release of my records, but understand there are exceptions afforded under FERPA and/or Virginia law that may require the release of my records.
The parent(s) or legal guardian(s) to whom I permit these disclosures are: * Required
First Name Last Name
The Home School Agent(s) to whom I permit these disclosures are: * Required
First Name Last Name
You must provide your parent(s)/legal guardian(s) or home school agent(s) with the password you choose below. If they are unable to provide the password, your records cannot be released unless otherwise permissible under Federal and State law.
Password * Required

(You are responsible for the security of this password. Protect it from unauthorized parties.)
• I give permission to Tidewater Community College to share my dual enrollment records and any performance concerns with the individuals listed above, and understand that these communications may occur in writing, in person, and over the telephone for the duration of my involvement in dual enrollment courses. * Required
- Agree
Student Signature * Required
I do not give permission to Tidewater Community College to share my dual enrollment records and any performance concerns with any person(s) other than high school personnel as permitted under FERPA. I also understand that there are additional exceptions under FERPA and Virginia law that allow and/or require TCC to share my records. For example, if I am a legal dependent, under U.S. Tax Code, my parent or legal guardian may access my educational records through a written request. * Required
- Agree
Student Signature * Required
*Any authorization permitted applies only to dual enrollment students whose education records are released, per this request, by dual enrollment personnel. Students seeking the release of records to and from individuals/entities other than those allowable herein, or when not an active dual enrollment student, may do so via completion of a Consent to Release form, accessible from https://help.tcc.edu/s/article/FERPA-Consent-to-Release-Educational-Records-form.

** Students may request the revocation of access. For details, contact your Dual Enrollment Coordinator.
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First Name	Last Name

First Name	Last Name

Commonwealth Dual Enrollment Pathways Program

Virtual Virginia Dual Enrollment Pathways Program

Student Eligibility

Parent or Legal Guardian Signature for Applicants under the Age of 18

Family Education Rights & Privacy Act (FERPA)

STUDENTS AND PARENTS: ACKNOWLEDGEMENT

CONSENT TO RELEASE EDUCATIONAL RECORDS