Parent/Guardian Financial Responsibility Form (for students under 18)

Parent/Guardian Financial Responsibility Form (for students under 18)

Dual Credit, Expanded Options, and other BMCC Credits
Student Information
Student Full Name

First NameLast NameJr., Sr., II, III, etc. Leave blank if none applies.
Student Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
BMCC ID or last 4 of SSN
Student Email Address
High School
Expected Graduation Year
Student: Please provide an email address for your parent/legal guardian
example@example.com
You have reached the end of your portion of the form. Please click the button below for the form to proceed to your parent/guardian.
Parent/Legal Guardian Information

To be completed by parent/legal guardian
Blue Mountain Community College (BMCC) requires a completed Financial Responsibility Form for any student under age 18 enrolling in BMCC credit-bearing coursework, including Early College Credit (ECC) students in DualCredit and/or Expanded Options courses.

ECC allows high school students to earn college credit while in high school through Dual Credit courses taught at the high school or Expanded Options courses taught by BMCC instructors. Dual Credit availability is determined by each high school. Expanded Options courses are subject to BMCC’s regular tuition & fees unless covered by the high school or another approved funding source. ECC courses are not eligible for financial aid. Current tuition and fee information is available at bluecc.edu
Parent/Legal Guardian Full Name

First NameLast NameSuffix
SSN/TIN
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Preferred Email
example@example.com
By submitting this Financial Responsibility Form, I understand and acknowledge/agree to the following:

• The student may register for eligible BMCC credit courses during applicable terms. I am responsible for any chargesnot paid by the high school or other approved funding source, which may have specific eligibility criteria.

• I accept full financial responsibility for all BMCC expenses incurred by the student listed above for the currentacademic year (ex. July 202x-June 202x).

• I accept responsibility for any outstanding balance owed to BMCC and acknowledge that BMCC may withhold credit extension and services for students with past-due balances. Outstanding accounts may be sent to collections.

• I agree to keep the student’s address current with BMCC and to notify BMCC within 30 days if the student changes high schools during the academic year, if applicable.

• BMCC courses, including Dual Credit and Expanded Options courses, become part of the student’s college record.Credits earned may apply to state and federal financial aid limits.

• Due to federal privacy regulations, BMCC will only share attendance, schedules, grades, billing details, or courseprogress with the student, not with parents/guardians or others unless a signed release is on file.

• All students, regardless of age, must follow BMCC policies for grading, attendance, registration, and paymentdeadlines. Official grades become part of the student’s permanent transcript and will not be adjusted due to age.

• BMCC courses are developed for adult learners and may include content and discussions appropriate for a college-level environment. These materials and conversations will not be adjusted for underage students.All students,regardless of age, are expected to demonstrate mature behavior.

Allow up to 5 business days for processing.
Unsigned or incomplete forms will not be processed.

Forms valid only for the academic year in which they are signed. (ex: July 1, 202x – June 30, 202x).
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Parent/Guardian Financial Responsibility Form (for students under 18)

Student Information

Parent/Legal Guardian Information