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High School Dual Enrollment Application

Welcome to the Pennsylvania Highland Community College Dual Enrollment Application. This application is reserved for high school junior and senior students who are enrolling in a college course(s) at a Pennsylvania Highlands location, or an online course.

In addition to completing the Dual Enrollment Application, prospective students must also submit a recommendation from their high school principal or guidance counselor. This process must be repeated for each semester in which a student intends to enroll while in high school.

All required fields must be completed in order for your application to be submitted.

After your form has been completed please review for errors and then click the submit button. You will receive a message indicating that your application has been submitted.

Questions regarding the application or the enrollment process can be directed to the Admissions Office at 814-262-6446.

General Information

First Name

Middle Name

Last Name

Email Address

Confirm Email Address

Address Information

Street

P.O. Box

City

State

Zip Code

County

Country

Residency Requirements

Tuition rates at Pennsylvania Highlands Community college are established by a student's residency. The Residency Policy can be found in the College Catalog.

How long have you lived at this address?

If less than one year, enter prior county and state of residence:

Primary Phone Number

Cellular Phone Number

Work Phone Number

Educational Goals

1. Which Location do you plan to attend?

2. I plan to attend

3. I plan to enroll in the following term

4. I plan to enroll in the following year

High School Information

Name of High School

City

State

Zip Code

Year of High School Graduation

Emergency Contact Information

Name of Person to Contact in Case of an Emergency

Contact Phone Number

Completion

How Did you Hear about Pennsylvania Highlands?

How Did you Hear about Pennsylvania Highlands?

Electronic Communication

The College may communicate with you in a variety of ways including email and text messaging. Please indicate below if you would like to opt out of receiving text and/or email messages from Pennsylvania Highlands Community College.

I wish to receive emails from Pennsylvania Highlands Community College.

I wish to receive text messages from Pennsylvania Highlands Community College.

Sign and Submit

By entering my name, I acknowledge that I have made application to Pennsylvania Highlands Community College and certify that the information provided on the application is true to the best of my knowledge.

Signature

Date

myPEAK

Dual Enrollment Application

Residency Requirements