Running Start Registration Form

Legal First Name:

Legal Last Name:

Middle Name:

Address:

City:

State/Zip:

Cell Phone:

Home Phone (enter your cell number if you do not have a home phone number):

Age:

Birth Date:

High School:

Graduation Month/Year:

High School Email:

Personal Email:

Legal Sex:

Male

Female

Ethnicity and Race:

Ethnicity:

Non-Hispanic/Latino

Hispanic/Latino

Please select any or all you identify with:

American Indian or Alaskan Native

Asian

Black or African American

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Choose not to respond

I would like to register for:

Fall

Spring

Summer

Course Selection:
Example: ENG 151-003 (Course Prefix is ENG, Course number is 151, Course Section is 003)
Course Prefix	Number	Section

Will you receive high school credit?

Yes

Terms and Conditions:
•   Course prerequisites must be satisfied as identified in the McHenry County College Catalog.
•   I am responsible for providing a copy of my high school transcript or home school academic record if requested.
•   I understand that when I enroll at MCC, the courses and grades will remain on my official college transcript.
•   If I desire high school credit in addition to college credit, I understand it is my responsibility to contact my school directly.
•   By signing this form, I give permission for MCC to disclose information related to my enrollment and progress at MCC to my parents and high school officials.

By checking this box, I acknowledge that I have read and understand the terms and conditions listed above.

Student Signature (printing my name serves as my e-signature):

Date:

Parent/Guardian Signature (printing my name serves as my e-signature):

Date:

Parent/Guardian Email: