CCP Application Creation Form

Academic

Program of Interest

Entry Term

Biographical Information

First Name

Middle Name

Last Name

Email Address

Birthdate

Mobile Phone

Would you like to receive text messages?

Mailing Address

Country

Street

City

Region

Postal Code

Are you Hispanic or Latino?

DeleteParent/Guardian _ID_
Parent/Guardian Information
Relationship Type First Last Email

Add Parent/Guardian

CCP Details

College Credit Plus Program Location

If intending on taking both on campus/online and high school class please choose the Hiram campus

Guidance Counselor First Name

Guidance Counselor Last Name

College Credit Plus Questionnaire

Any student wishing to enroll in any college course under the College Credit Plus program must complete this questionnaire.

A student eligible to participate in College Credit Plus and admitted to a college/university will enroll in actual college courses, which may include “mature subject matter” as defined in Ohio Revised Code 3365.035.

Select one choice in response to each question:

Do you possess the necessary social and emotional maturity to participate in the College Credit Plus program?

Yes

No

Are you ready to accept the responsibility and independence that a college classroom demands?

Yes

No

Academic History

Please note the following:

For applicants pursuing undergraduate classes, we require your high school.

High School

Acknowledgements & Signature

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony?

Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade forward, whether related to academic misconduct or behavioral misconduct, that resulted in disciplinary action?

I certify that all information submitted in the admission process - including this application and all supporting information to come - is my own work, factually true, and honestly presented. I authorize Hiram College to review my application, and I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, should the information I've certified be false.

I agree

Signature

Your final step to complete your College Credit Plus application is to download this permission form, have your parent sign it and upload it to your portal. You will receive a separate email with instructions on setting up your portal shortly. Please follow those instructions, set up your portal and upload this permission form.