Northwood

Thank you for working with students through this process. This form is to verify the eligible charges per semester for the Early Middle College program or Dual Enrollment classes at NU. Please keep this form handy to complete for your student each semester they enroll in classes at NU.

Eligible charges that can be paid are as follows: tuition, mandatory course fees, material fees, registration fees, textbooks, and late fees charged by the postsecondary institution for late district payment. Textbooks paid for by the district are considered the district’s property and are listed below.

Are you completing this form for a Dual Enrollment or Early Middle College Student?

Student's First Name

Student's Preferred Name

Student's Middle Name

Student's Last Name

Birthdate

Student's Email Address

High School

High School CEEB (hidden)

HS Level of Study (hidden)

Counselor's/Designated School Official's Email Address

How many high school classes per term does a typical full-time student Enroll in?

How many high school courses is the dual enrollment course being counted as? (Most commonly 1 or 2)

College Course Name

# of Credits

High School Credit Issued For:

# of Credits

District Tuition Responsibility:

Other District-eligible Charges

Please provide an updated transcript each year the student enrolls in courses at NU. You may upload an updated copy of the students unofficial transcript below. Or, if you are not able to upload it, please email it to admissions@northwood.edu.

This form acts as the district’s verification of your eligibility for dual enrollment.The following information is presented on the application for Early Middle College and dual enrollment.

By enrolling in courses at NU, the student agrees to...
• That you are responsible for paying the remainder of the costs associated with the class(es) listed above that exceed the minimum amount the school district must pay.
• That you are responsible for any late fees, transportation, parking cost, and any other costs incurred that are not outlined in this letter.
• To reimburse the district’s cost if you are unsuccessful in the courses listed.
• To release attendance and transcript records to the district as required.

EMC & DE: Tuition Authorization Form