Dual Enrollment Application

Personal Information

Student Email Address

Student Birthdate

Student Preferred Name (Enter ONLY if different from your first name above).

Student First Name

Student Last Name

Student Phone Number

Sex

I identify my gender as

Are you a Pennsylvania state resident?

Yes

No

How many years have you been a permanent full time resident in Pennsylvania? (0-100) If less than 1 year please enter 0.

Course Selection

Mailing Address

Country

Street

City

Region

Postal Code

Primary Citizenship

What is your official state of Permanent Residency, if residing in the United States?

Please provide up to three class choices in order of preference.

What term do you plan to take classes?

How many classes would you like to take?

Preferred Class Choice 1

Preferred Class Choice 2

Preferred Class Choice 3

Preferred course not listed? Tell us what you're looking for.

Educational Information

What school do you currently attend? (Start typing your school name and pick from the dropdown.)

What year do you graduate high school?

When you attend college full time, what will be your intended major? (Select One)

Concentration (Select One)

Parent/Guardian Information

Please provide parent/guardian information for communication purposes.

Parent/Guardian Email Address

Parent/Guardian First Name

Parent/Guardian Last Name

Would you like to:

Add another parent/guardian

Parent/Guardian Email Address

Parent/Guardian First Name

Parent/Guardian Last Name

Material Uploads

To complete your dual enrollment application, upload or send your high school transcripts and the below documents:
Financial Terms & Conditions Agreement (download form)
Authorization Form (download form)

Any materials can also be sent to admissions@pennwest.edu.

Financial Terms & Conditions Agreement

Parental Consent Form

Unofficial Transcripts