Midland College Dual Credit Parent/Student Agreement Form

The MC Application for Admission and all test scores must be on file with the MC Admissions Office prior to enrolling in class.
All fields are required.

Academic Year for this Agreement:

Student SSN or MC ID: Parent Email Address:
Last Name:  First Name:
High School:  Date of Birth:
Anticipated Graduation Date: Student Email Address:
Parent Phone #:
Home Street Address: City:
State: Zip Code:
Check if okay to text student/parent: Preferred text number:



As a dual credit student I understand and agree to the following in order to enroll and receive college credit:

  • I must meet the high school’s guidelines and be approved to take dual credit courses.
  • I understand that the SSN provided may be used to update my Midland College records, if not previously provided.
  • I understand that all forms and documentation, including: MC Application for Admission, Parent/Student Agreement (renewed each fall semester), and test scores (TSI, STAAR EOC, PSAT/NMSQT, PLAN or ACT/SAT) must be submitted before enrollment/registration.
  • I must meet the requirements of the Texas Success Initiative (TSI) for the subject area(s) that correspond to the courses I wish to take.
  • I understand that I must take the free math placement test if I plan to register for a higher level math class than Math 1314, Math 1324 or Math 1342 if I have not yet met the prerequisites.
  • I am a high school age student.
  • I understand that I am not officially enrolled until all required registration documents and payment have been submitted to the college. Payment is due at the time of enrollment. If I do not make payment at that time, I understand that I am subject to being dropped for non-payment. If I am allowed to be reinstated after the census date, an additional reinstatement fee will be applied.
  • I understand that dual credit courses are college-level, and I agree to comply and follow all policies of Midland College and the school district.
  • I understand that I must notify Midland College by completing the withdrawal process either online or in person if I decide to drop or withdraw from my courses. Midland College must be notified by last date to withdraw (see college calendar).
  • I give permission to enroll in interactive videoconference classes that are transmitted from the college to the high school if scheduled by the high school, and I give permission for these classes to be recorded and uploaded to a password-protected website link.
  • I understand that my signature/electronic signature gives the high school permission to send to Midland College all required test scores, enrollment documentation, as well as my final transcript upon graduation. My signature/electronic signature also allows Midland College to release my education records to the parent or guardian listed below upon their request and to the high school until such time as I am no longer enrolled at the high school.

Please enter one of the following as your electronic signature: DL#, High School ID#, Midland College ID# or Pin:

Parent/Guardian Permission

Please enter your Driver’s License number or State Identification Number, if you give permission for the above student to enroll in Midland College’s Dual Credit program. As a parent/guardian for the above mentioned student, I have read and agree with all conditions and requirements of enrollment and registration outlined above.

Parent/Guardian Name:  Date:

Driver's License Number or State ID Number:              State:


Please click the submit button to continue.