DUAL ENROLLMENT COURSE SELECTION FORM - TUSCULUM UNIVERSITY ADMISSION

Student Information

Student Name*

First Last

Student Preferred Email*

Student Home Phone

Student Mobile Phone

Student High School*

Pursue an Associate's Degree*

Are you interested in pursuing your Associate's Degree while taking Dual Enrollment classes?

YES
NO

Term & Classes Selection

2027 Spring Session

Full: January 19 - May 7, 2027
Early: January 19 - March 12, 2027
Late: January 19 - May 7, 2027

Term Requested*

Please select the term(s) you wish to take Dual Enrollment courses at Tusculum

Spring 2027

Do you want to take these courses ONLINE or IN-PERSON*

Please select your preference.

Summer Term Classes

Full: May 18 – August 7, 2026
Early: May 18 – June 26, 2026
Late: June 29 – August 7, 2026

Summer Term Class*

Summer Term Class 2*

Summer Term Class 3*

Summer Term Class Other

If the course you want is not listed, please enter it here.

Fall Term Classes

2026 Fall Session: Full: August 17 – December 11, 2026
Early: August 17 – October 16, 2026
Late: October 19 – December 11, 2026

Fall Term Class*

Fall Term Class 2*

Fall Term Class 3*

Fall Term Class Other

If the course you want is not listed, please enter it here.

Spring Term Classes

2027 Spring Session: Full: January 19 - May 7, 2027 - Early: January 19 - March 12, 2027 - Late: January 19 - May 7, 2027

Spring Term Class*

Spring Term Class 2*

Spring Term Class 3*

Spring Term Class Other

If the course you want is not listed, please enter it here.

Will you be taking dual enrollment courses at another institution at the same time you are taking dual enrollment courses with Tusculum University?*

Yes
No

If so, what courses and which institution?*

Have you taken dual enrollment courses through another institution?*

Yes
No

If so, which institution(s) and when?*

Dual Enrollment Guidelines

Some courses may have an additional course fee that is not covered by the dual enrollment grant. Required high school GPA is a 2.75. Required college GPA is a 2.0.

By checking the box below I am certifying that I understand the following:

I understand that I must maintain an overall college GPA of 2.00 (C average) in my dual enrollment courses to keep my Dual Enrollment Grant and/or Scholarship.

I understand I must complete the application on-line at https://www.tn.gov/collegepays/article/tsac-student-portal to be considered for the Dual Enrollment Grant and Tusculum University Dual Enrollment Scholarship or I will be responsible for all tuition and fees due.

I understand that I will be responsible for any possible additional course fees associated with the course(s) I am registered for each semester.

I understand that I am providing consent for information regarding my admission and records to be discussed with my parent(s) and/or guardian(s) while enrolled as a dual enrollment student.

I understand I will be subject to the university's established academic and administrative policies located in the institution's catalog and student handbook.

I understand these Dual Enrollment Guidelines:

I understand the Dual Enrollment Guidelines:*

YES

To be completed by Parent/Guardian

Some courses may have an additional course fee that is not covered by the dual enrollment grant. Required high school GPA is a 2.75. Required college GPA is a 2.0.

By entering my name below I am certifying that my son or daughter or ward has my permission to enroll at Tusculum University as a special student.

I understand the guidelines concerning his/her admission and the regulations regarding registration for classes.

I understand that my son/daughter/ward must maintain an overall college GPA of 2.0 (C Average) in their dual enrollment courses to keep their Dual Enrollment Grant and/or Scholarship.

I understand that my son/daughter/ward will be responsible for any possible additional course fees associated with the course(s) they are registered for each semester.

I understand that my son/daughter/ward is subject to the university’s established academic and administrative policies located in the institution's catalog and student handbook.

Parent or Guardian Signature

Please type Parent or Guardian name

To be completed by Guidance Counselor/Principal

The student mentioned above has the following criteria

Current grade in High School:*

9th
10th
11th
12th

High School Graduation Date*

Please enter your anticipated graduation date

Academic GPA

ACT/PLAN Composite Score:

Please enter a number from 0 to 36.

ACT/PLAN Math Score:

Please enter a number from 0 to 36.

ACT/PLAN English Score

Please enter a number from 0 to 36.

By typing my name I am recommending the above named student to participate in Dual Enrollment with Tusculum College if he/she is selected. Official transcripts and test scores will be submitted. If necessary I will be a proctor or will provide a proctor that is a school professional for final examination.

Guidance Counselor Name:*

First Last

Guidance Counselor Email*

Guidance Counselor Phone

Authorization to Release Grades

By checking the box below, I authorize Tusculum to release my transcript of academic work to my high school, after attending Tusculum as a Dual Enrolled student. I understand this permission form only applies while attending Tusculum under the status of Dual Enrollment.

Authorization to Release Grades*

YES