Jackson State Community College - Dual Enrollment Checklist
 Talk with your School Counselor to determine your eligibility and your high school scheduling.
 Dual Enrollment Participation Requirements:
 3.0 High School GPA
 ACT (or PLAN) Score 18 English, 19 Reading, 19 Math (or SAT equivalents)
 Accuplacer challenge exam is also available
 Complete your Dual Enrollment Application –
 Visit www.jscc.edu/Admissions for our web application and create as a new user.
 Submit a completed DE Signature page (Each section must be complete.)
 If you’re 18 years of age, submit a copy of your TN Driver’s license or TN birth
certificate.
 For males who turn 18 before their application date, register for Selective Service at
www.sss.gov . This is an eligibility requirement for the DE grant as well.
 High School Transcript - Submit a copy to the JSCC Dual Enrollment Office.
 Test Scores –
 If you have taken the ACT, SAT or PLAN test, make sure those scores are sent to JSCC
(they often are included on your high school transcript or if you selected JSCC as a
receiving institution when you took your ACT, we will get them directly from ACT)
 If you have not taken a placement test, you may take the ACCUPLACER test to
determine your eligibility for dual enrollment courses. Please talk with your counselor
or call the JSCC Dual Enrollment office to schedule this test.
 TN Dual Enrollment Grant Application
www.tn.gov/collegepays
 The grant provided by the Tennessee Student Assistance Corporation will currently
provide one grant per semester for tuition for high school juniors and seniors
enrolled in college credit courses. It is the student’s responsibility to apply for this
grant each semester. Students who qualify for the HOPE Scholarship (3.0 GPA or 21
Composite ACT score) can receive one additional grant in the same semester.
 Students must maintain a 2.75 College GPA to receive the grant in future semesters.
 Deadlines to apply for the TSAC grant are as follows:
 Fall 2017
– September 15, 2017
 Spring 2018
– February 1, 2018
 Summer 2018
– May 15, 2018
Please direct any questions to:
JSCC Dual Enrollment & Student Recruitment Office (731) 425-2601
MIKE KRAUSE
BILL HASLAM
Executive Director
Governor
STATE OF TENNESSEE
TENNESSEE STUDENT ASSISTANCE CORPORATION
PARKWAY TOWERS, SUITE 1510
NASHVILLE, TENNESSEE 37243-0820
(615) 741-1346
FAX: (615) 741-6101
www.state.tn.us/thec/
Dual Enrollment Grant at a Glance
 Students must be a Tennessee resident (as defined by the TBR) for 1 year prior to the application
deadline date
 Students must submit an application by the deadline date for each semester:
Except for weekends and holidays, then it is extended to the next business day


September 15 fall, February 1 spring, May 15 summer (Community Colleges and Universities)
November 1 fall, March 1 spring, May 15 summer (Tennessee College of Applied Technologies)
 Students must have completed the 10th grade, by the date of enrollment in a dual enrollment
course, and be considered a junior or senior by the student’s high school
 Must meet the admissions criteria for dual enrollment at the postsecondary institution in which
they are enrolled
 Students attending a college or university are eligible for award amounts as follows:
 Course #1 – up to $500
 Course #2 – up to $500
 Course #3 – up to $200
 Course #4 - $0
 Courses 5 – 8 up to $100 per credit hour
 Award amounts for courses 5 – 8 cannot exceed $600 per semester ($1,200 per
academic year)
 Students attending a Tennessee College of Applied Technology (TCAT) are eligible for award
amounts as follows:
 Up to $100 per clock hour for courses 1 – 8
 Award amounts for courses cannot exceed $600 per semester ($1,200 per academic
year)
 Students can only receive an award for 1 course per semester. To receive funds for an
additional course per semester (not to exceed 2 per semester, 4 per academic year) the student must meet the
minimum HOPE Scholarship eligibility requirements
 Any award received past 4 courses reduces the student’s HOPE Scholarship on a dollar for
dollar basis. As part of the application process, students e-sign a statement that they understand this process. Once students are paid
for 4 courses, if they have an application on file for subsequent semesters, they receive an email stating their HOPE Scholarship will be
reduced
 To be eligible for continuation, a student must maintain at least a 2.75 cum college GPA for all
courses attempted while participating in the DEG program. The student must also submit an
application for the semester by the appropriate deadline
03/14/17
How to submit a JSCC Dual Enrollment web application
1. Go to www.jscc.edu. Choose “Apply Now” at the top of the page and select “Apply for Admissions Online”.
2. You’ll create a user account by entering a Login ID and PIN (Login ID can be up to nine alphanumeric characters.
PIN must be six numbers. Enter your PIN again to verify it and then select Login.) Remember your PIN and ID!!!
3. On the next page, select the “Dual Enrollment” application type and choose continue. Choose the term for
which you are applying and select “Fill Out Application”. Information marked with a red asterisk must be
entered but do answer all other questions as they apply to you.
4. On the next page, you’ll see the checklist items. Select the “i” icon in front of each item section to enter the
required information.
5. Choose “Continue” to proceed on to the next checklist item. (At any time you may either return to the Checklist
by choosing “Checklist” or work on the application at a later time by choosing “Finish Later”. You’ll need to
remember your Login ID and PIN)
6. The final checklist item is called “Additional Information”. This information is a question related to your
potential enrollment with another college, university or Tennessee College of Applied Technology (TCAT) while
enrolling with JSCC. If you’re using the Tennessee Dual Enrollment grant (TN DEG) to pay or help with tuition
costs at JSCC the other institution, you will need to initiate a consortium agreement and submit transcripts from
the other institutions. These are required to request the grant funds and determine your eligibility for the grant.
7. When each checklist item has a red checkmark beside it, you can submit the application by choosing
“Application is Complete”.
8. Carefully read the “Admissions Agreement” and select “I agree to the terms” to continue the application
submission.
9. Complete and return the JSCC Dual Enrollment application signature sheet which includes a parent or guardian’s
signature as well as yours to the JSCC Admissions Office or your guidance counselor.
Important Note:
YOUR APPLICATION IS NOT COMPLETE WITHOUT THE SIGNATURE SHEET THAT INCLUDES YOUR SIGNATURE
AND A PARENT/GUARDIAN SIGNATURE.
10. Do you intend to use the Dual Enrollment Grant provided for High School Juniors and Seniors?


Complete the Tennessee Dual Enrollment Grant application at www.tn.gov/collegepays . Choose “Money
For College”, then choose “Grant Program” and finally “Dual Enrollment Grant”. Complete the application
by selecting the “Online Application” option. Select Jackson State Community College for your school in the
“College/University Information Section”. Remember, YOU MUST SUBMIT an application for each semester
you wish to use the grant. Failure to do this will result in you being responsible for your course tuition.
If you have college credit at another institution where you may or may not have used the TN DE grant,
submit official copies of the transcript to the JSCC Admissions Office:
JSCC Admissions
2046 N Parkway
Jackson, TN 38301
Fax (731) 425-9559

Will you be using a grant with JSCC and another institution in the same semester? If so, you’ll need to
contact JSCC or the other institution (depending upon which institution you selected to receive the grant in
your TSAC account) in order to initiate a “consortium agreement” between JSCC and the other institution. A
TN DEG consortium agreement is a document signed by you and both institutions to enter an agreement
where two schools can receive your grant funds in the same semester.
If you have questions about your application please call the JSCC Recruiting Office at (731) 425-2601 or
Admissions Office at (731) 425-8844. You can also e-mail Admissions at [email protected]
Dual Enrollme
E
ent Signatture Pagee
The Fa
amily Education
nal Rights and Privacy Act of 1974 as amend
ded (FERPA), rrequires the folllowing informa
ation so that we
e can release
studentt information to
o parents/guard
dians. Please complete and sign.
I give m
my permission for
f the Dual Studies Departm
ment at Jackson
n State Commu
unity College to release my infformation to __
_____________
__
High School and/or
admissions req
quirements,
, my parent(s)//legal guardian(s), regarding a
registra
ation, grade, an
nd fee paymentt information du
uring my enrollm
ment as a duall enrollment stu
udent.
Studentt’s Signature
Parent/Guard
dian’s Signature
Print Stude
ent’s Name
D
Date
Print
P
Parent/Gu
uardian’s Name
e
D
Date
m
Hepatitis B Immuniization Health History Form
All Studen
nts Must Comp
plete
General Assemb
bly of the State
e of Tennessee mandates thatt each public or private postse
econdary institu
ution in the statte provide
The G
inform
mation concerning hepatitis B infection
i
to all students
s
matric
culating for the first time. Tennessee law req
quires that such
h students
compllete and sign a waiver form prrovided by the institution that includes detaile
ed information about the disea
ase.
The la
aw does not req
quire that stude
ents receive vaccination for en
nrollment. Furtthermore, the in
nstitution is nott required by law to
provid
de vaccination and/or
a
reimburs
sement for the vaccine.
Hepatitis B (HBV) Immun
nization
Hepatitis B (HBV) is a se
erious viral infection of the liver that can lea
ad to chronic liver disease, ccirrhosis, liver
cancer, live
er failure, and even
e
death. Th
he disease is trransmitted by b
blood and or bo
ody fluids and many people w
will
have no symptoms when they develop the
t disease. Th
he primary riskk factors for He
epatitis B are ssexual activity a
and
ug use. This disease is comp
pletely preventa
able. Hepatitiss B vaccine is a
available to all age groups to
o
injecting dru
prevent Hepatitis B viral infection. A serries of three (3
3) doses of vacccine are requ
uired for optima
al protection.
Missed dos
ses may still be sought to com
mplete the series if only one orr two have been
n acquired. The
e HBV vaccine
e
has a recorrd of safety and
d is believed to confer lifelong immunity in mo
ost cases.
I he
ereby certify tha
at I have read th
his information and I have ha
ad the entire se
eries of the He
epatitis B vacc
cine.
ereby certify tha
at I have read th
his information and I have ele
ected not to re
eceive the Hep
patitis B vaccin
ne.
I he
ereby certify tha
at I have read th
his information and I have ele
ected to receiv
ve the Hepatitiis B vaccine a
and/or
I he
I am
m in the proce
ess of receiving the complette three dose s
series of the H
Hepatitis B vac
ccine.
Signatture of Studentt
(Paren
nt/Guardian mu
ust sign if stude
ent is under 18))
Da
ate
w
info
ormation on this application or giving false
e information m
may make me ineligible for admission to, or
I understand that withholding
contin
nuation in, Jack
kson State Com
mmunity Colleg
ge. Accordingly
y, I certify that a
all of the inform
mation and stattements provided by me on th
his
appliccation are corre
ect and complete. Further, if I am admitted
d to Jackson S
State Community College, I agree to abide by the rules an
nd
regula
ations of the institution.
In addition to the fo
orgoing, the Te
ennessee Eligiibility Verification for Entitlem
ments Act requ
uires an appliccant for in-state
e tuition or sta
ate
financcial aid to attes
st under penalty
y of perjury tha
at he or she is either
e
a United
d States citizen or alien lawfully present in th
he United State
es.
By su
ubmitting this application,
a
I am
m attesting thatt I am either a United States citizen or alien
n lawfully prese
ent in the Unite
ed States or I am
a
not re
equesting any state
s
benefits in
ncluding in-statte tuition.
erstand that th
his attestation is required by Tennessee
T
law
w if I have app lied for a state
e public benefitt. I understand that Tennesse
ee
I unde
law re
equires me to provide docum
mentation verify
ying the status
s indicated abo
ove prior to recceipt of this sta
ate public bene
efit. I understan
nd
that kknowingly and willfully makin
ng a false, fictiitious, or fraud
dulent stateme nt or represen
ntation shall su
ubject me to liability under th
he
Tenne
essee False Claims
C
Act, Ten
nnessee Code
e Annotated 4--18-101 et seq
q. I understand
d that if I am fo
found to have made a false or
misleading statemen
nt, my state public benefits may be rescinde
ed or I may be d
disciplined by tthe college.
Signatture of Studentt
__D
Date
Jackson State Community College is accredited by the Com
mmission on Colleges-So
outhern Association off Colleges and Schools tto award degrees at th
he associate level. Conttact the Commissions o
on Colleges at 1866 Sou
uthern
Lane, Decaturr, Georgia 30033-4097 or call 404-679-4500 for
f questions about thee accreditation of Jacksson State Community C
College. http://www.saacscoc.org. TBR does n
not discriminate on thee basis of race, color, na
ational
origin, sex, dissability, or age. For inqu
uiries regarding non-discrimination policies, contact [email protected]. HSI14-6344