Beruflich Dokumente
Kultur Dokumente
LSA is a college program for high school seniors who have completed State of Florida
graduation requirements prior to their commencement.
It is NOT dual enrollment and does NOT earn high school credit.
Students enrolled in a public or private high school or home school may enroll in a maximum of 12 hours of college
credit coursework with parental consent, if they can document that they have completed all requirements for high
school graduation. Students enrolling under this provision must qualify for college level coursework through
assessment, and are responsible for all tuition and fees.
PERSONAL INFORMATION
Name____________________________________________________________________________________________
Last
First
Middle
)__________________________________
*In compliance with Florida Statute 119.071(5), Florida State College at Jacksonville issues this notification regarding the purpose of the collection and use of Social Security
numbers. Florida State College will collect your Social Security Number (SSN) for record identification, state and federal reporting. Providing your SSN on this application means
that you consent to the use of your number in the manner described. If you choose not to provide your SSN, you will be provided an alternate identification number. All Social
Security Numbers are protected by Federal regulations and are not to be released to unauthorized parties. Read more about the collection and use of social security numbers
(http://www.fscj.edu/ssn).
Mailing Address___________________________________________________________________________________
Number and Street or P.O. Box
Apt. #
________________________________________________________ E-Mail___________________________________
City
State
ZIP Code
)___________________(
)_________________
Home
Work
ENROLLMENT PLANS
College course(s) for which this application is intended:
Term
College Course #
Ref. #
Course Title
or
or
Location of Class
TEST SCORES
To qualify for enrollment in the Limited Special Admission program, official test scores must be on file or attached.
Please mark one of the following:
SAT-Attach a copy of test results (less than two years old.)
ACT- Attach a copy of test results (less than two years old.)
PERT- Scores must be on file at College assessment services department.
STUDENT AGREEMENT
To be completed by Student
I hereby apply for admission to Florida State College at Jacksonville and agree to abide by all rules and regulations of
the College.
FLORIDA RESIDENCY-I understand that in order to qualify for Florida residency for tuition purposes for the term for
which this application is submitted I must complete a Residency Affidavit prior to the beginning of the term. I
understand that if I do not submit a Residency Affidavit with supporting documentation, I will not be eligible for in-state
tuition rates.
I understand that to continue enrollment at Florida State College at Jacksonville as a degree seeking student after
graduation, I must submit:
o
o
o
An official copy of my final high school transcript, GED passing scores, or home school affidavit. Please note: we
will automatically request your high school transcript if you graduated from a public school in Duval or Clay
counties.
An official college transcript (if applicable) from each college attended, and
Log into my online student portal Connections and select the My Programs of Study/Degree Audit link to request a
Program of Study (POS) change.
I have checked this application for errors and certify that the information is accurate and complete.
FloridaStateCollegeatJacksonvilleprovidesequalaccesstoeducation,employment,programs,servicesandactivitiesanddoesnotdiscriminateonthebasisofage,race,color,national
origin,sex,disability,religiousbelief,ormaritalstatus.TheCollegeEquityOfficerhasbeendesignatedtohandleinquiriesregardingthenondiscriminationpoliciesandmaybecontactedat
equityofficer@fscj.edu.FloridaStateCollegeatJacksonvilleisamemberoftheFloridaCollegeSystemandisnotaffiliatedwithanyotherpublicorprivateuniversityorcollegeinFloridaor
elsewhere.FloridaStateCollegeatJacksonvilleisaccreditedbytheSouthernAssociationofCollegesandSchoolsCommissiononCollegestoawardthebaccalaureateandassociatedegree.
Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 300334097, or call (404) 6794500 for questions about the accreditation of Florida State College at
Jacksonville.TheCommissionistobecontactedonlyifthereisevidencethatappearstosupportaninstitutionssignificantnoncompliancewitharequirementorstandard.