Dual Enrollment Registration Form

Statement of Eligibility for Dual Enrollment for Dual Credit Students

Your acceptance to the Dual Enrollment for Dual Credit program at Northwest-Shoals Community College will be official only upon receipt of form, completed and approved by the counselor of your local school, and a completed Application for Admission for Dual Enrollment for Dual Credit.


Please list the name and email address of your parent or guardian below and check Yes next to the authorization statement below. Your parent/guardian will receive a notice that your dual enrollment registration form has been processed and will be able to see the complete processed form.

Nondiscrimination Policy: It is the official policy of the Alabama Department of Postsecondary Education and Northwest-Shoals Community College that no person in Alabama shall on the grounds of race, color, disability, sex, religion, creed, national origin, or age, be excluded from participation, be denied the benefits of, or be subjected to discrimination under any program, activity, or employment. The College complies with nondiscriminatory regulations under Title VI and Title VII of the Civil Rights Act of 1964; Title IX Education Amendment of 1972; Section 504 Rehabilitation Act of 1973; and the Americans with Disabilities Act (ADA) of 1990.


To maintain continuous eligibility, student must earn a C or better in all attempted college courses. Students who fail to meet this minimum GPA or withdraw from a course will be suspended from the program for a minimum one term. The one-term suspension may not be served during the summer.

Authorization for Release of Records

According to the Family Educational Rights and Privacy Act of 1974 (FERPA), all rights of access to students' educational records transfers from the parent(s) to the student when the student becomes 18 years of age OR are enrolled in an institution of postsecondary education.  In order to comply with the requirements of FERPA, Northwest-Shoals Community College shall obtain written consent from students before disclosing any personally identifiable information from his/her educational records.

As a participant in the Dual Enrollment for Dual Credit program, I understand that it is the responsibility of Northwest-Shoals Community College to release my grades and any additional information listed below to my high school and/or secondary educational entity.

  • Admission/Transcript Records (records include transcripts, admission and registration information, schedule information, and any other information contained in the academic records)

  • Student Account Records (records include amounts due for tuition and fees, sources of payment for tuition and fees, refund information, records hold information as it relates to parking tickets, library fines, and financial aid repayments, and any other accounts receivable information contained in the student account records)
 Checking below serves as my signature to authorize the College to release the information noted in this section.