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Dual Enrollment Application

About You

Note: Almost all male U.S. citizens, and male immigrants living in the U.S., who are 18 through 25, are required to register with Selective Service. It's important to know that even though he is registered, a man will not automatically be inducted into the military. In a crisis requiring a draft, men would be called in sequence determined by random lottery number and year of birth. Then, they would be examined for mental, physical and moral fitness by the military before being deferred or exempted from military service or inducted into the Armed Forces.

Contact Information
Please Answer the Following:
* has worked primarily without remuneration to care for a home and family and for that reason has diminished marketable skills. * has become dependent on the income of another family member but is no longer supported by that income; or * is a parent whose youngest dependent child will become ineligible to receive assistance under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.) not later than 2 years after the date on which the parent applies for assistance under this title; and *is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment.
An individual from an economically disadvantaged family is one who is determined to be low income according to the latest available data from the Department of Commerce. Students who qualify for need-based financial aid/benefit programs are generally classified as economically disadvantaged. Foster children or students who are wards of the State would also be classified as economically disadvantaged.
A single parent is an individual who is unmarried or legally separated from a spouse, who has a minor child or children for whom the parent has either custody or joint custody, or who is pregnant.
Disability is defined in Section 3 of the Americans with Disabilities Act (ADA) of 1990 (42 U.S.C. 12102) as a physical or mental impairment that substantially limits one or more of the individual's major life activities, such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. More definitive information from Section 504 of the Rehabilitation Act of 1973 states that term "physical or mental impairment" may include, but is not limited to, conditions such as visual or hearing impairment, mobility impairment, HIV infection, mental retardation, drug addiction (except current illegal use of or addiction to drugs), or mental illness. Students who are sponsored through the Department of Human Services, Division of Vocational Rehabilitation or Veterans Affairs, Vocational Rehabilitation division, have been determine to have a disability.
Program Options
Digital Signature

By typing my name, I understand that withholding or giving false information requested on this form may make me ineligible for admission to the Tennessee College of Applied Technology. I certify that the information I have provided on this form for enrollment to be correct and complete.

I recognize that in the event that my student does not maintain a 2.75 GPA on a scale of 4.0, equates to a minimum average of 80.5 at the beginning of his or her second (2nd) semester; he or she will lose the ability to receive funds to cover tuition through the Dual Enrollment Grant and thus causing my student to be withdrawn from the program.  However, I am also aware that as the parent or guardian, in this instance, I have the option to pay the dual enrollment fee should I wish for my student to remain in the Dual Enrollment program and thereby receiving the benefits TCATN has to offer those enrolled in this program. This amount ranges from $100.00 to $300.00 per semester, which is based on the amount of hours my student would register for.  All fees must be paid upon registration.