Microsoft Word - ICE UCM-MC application form

MERCED COLLEGE

UNIVERSITY OF CALIFORNIA, MERCED

Office of t

he Registrar (209) 228-7178

Office of the Registrar (209) 384-6000

Application for Intersegmental Cross Enrollment

Complete

the student portion of this form, obtain advisor approval, and submit the form to your home campus Registrar’s office. The Registrar’s representative

certifies the form and attaches an unofficial transcript. When instruction begins for the semester, obtain instructor approval on the form. (Enrollment is on space-

available basis only, and special enrollment procedures may apply for some courses). Submit the form with all the necessary approvals, the unofficial

transcript, and payment to the host Registrar’s office. A Registrar’s representative will check course prerequisites and enter the registration if approved. Note: There

is a nonrefundable administration fee of the current per unit fee that must accompany the application. There may also be course material fees required of

all students who apply for some courses. (Please see back of this form for additional requirements and conditions.)

Current Ho

me Campus:

Planned semester of cross enrollment: Prior ICE particip

ant to host campus:

☐

UC Merced ☐ Fall ___________ ☐ No

☐ Me

rced Colleg

☐

Spring

(Year) ☐ Yes (If yes, include SID#)____________________

A. Personal Information

Student ID Number:___________________________________

Last name

_______________________________________

First

______________________________________

Middle

_____________________________

______________________________________________________________________________________________________________________

Street City State Zip

Email: ______________________________________ Message Phone: (______) _______ - _______________

Social Security No: ________ - ______ - _________ Birth Date: ______/______/______ Ethnicity: ______________________________

U.S. Citizen: ☐ Yes ☐ No * (Citizenship information will only be used for purposes of statistical analysis.)

*If Not U.S. Citizen, Country of Citizenship: ___________________________________

*If not U.S. Citizen, Country of Permanent Residence: __________________________

If not U.S. Citizen, Present Immigration Status:

☐Immigrant/U.S. Permanent Resident ☐Refugee ☐Nonimmigrant * *If Nonimmigrant, VISA Code ___________ VISA Dates _______________

I certify the information provided is accurate and I have read and understand eligibility requirements, enrollment conditions, and procedures stated.

My signature authorizes the exchange of my education record data between the home and host campuses.

Date:________________________________ Signature:___________________________________________________________________

B. Campus/Advisor Pre-approvals (Your home campus must approve eligibility to ICE program before Instructor Approval)

MERCED COLLEGE REGISTRAR (Merced College students only): Student meets cross enrollment eligibility requirements.

______________________________________________________________________________________________________________________

Name (Please Print) Title Signature Date Seal

UC MERCED ADVISING (UC Merced students only): Course will apply to degree program listed below.

______________________________________________________________________________________________________________________

Academic Advisor Name (Please Print) Title Signature Date Degree Program

________________________________________  12 units completed  Enrolled in 12 units  2.0 gpa or higher  Never acad. disqualified  Fees paid

Registrar Approval Date

C. Instructor Approvals/Registration Information: (Instructor approves course registration on the first day of instruction)

CRN Subject Course Section Units Grade Option Instructor’s Signature Date

Reason for taking c

ourse:________________________________________________________________________________________________

UC USE ONLY:

06/22/2015

ID#___________________________________  Note on Transcript  Student Notified  Paid Fees

Prerequisites Checked/ICE Entered By_______________________________ Date______________________________

MERCED COLLEGE

UNIVERSITY OF

CALIFORNIA, MERCED

Office of the Registrar (209) 228-7178

Office of the Registrar (209) 384-6000

POLICIES AND PROCEDURES FOR CROSS ENROLLMENT

1. The host institution whose course is being taken under the auspices of the Intersegmental Cross-Enrollment Program wi

col

lect applicable per unit course fees for the specific course related to the program. Note: There will be no non-resident fee

charged by the host campus for participants of the program.

2. The host institution whose course is being taken under the auspices of the Intersegmental Cross-Enrollment Program wi

prov

ide the home institution an ‘official’ academic transcript at the conclusion of the course, at no additional cost to t

stud

ent.

Eligibility Requirements:

Undergraduate students enrolled at any campus of the California Community Colleges, the California State University, or the University

of California may enroll without formal admission in a maximum of one course per academic term at a campus of either of the other

systems if there is an agreement in place between the respective institutions. Enrollment is on a space available basis at the discretion

of the appropriate campus authorities on both campuses. Enrollment in pre-collegiate courses is excluded.

3. A student is eligible to participate in the Intersegmental Cross-Enrollment Program if he/she meets the following guidelines:

a. Have completed one semester as a matriculated student and has completed 12 units of degree applicable work at th

hom

e institutio

b. Is enr

olled in 12 units at the home institution during same term as being a program participan

c. Has

earned a cumulative GPA of 2.0 for all work completed.

d. Has paid appropriate tuition and fees at the home institution for the term of participation.

e. Has not been academically disqualified from either institutio

Enrollment Conditions:

4. The e

nrollment conditions necessary to participate in the program are as follow

a. App

roval is valid for only the one term specified and subject to space availability, deadlines, registration procedures, and

priorities of each respective institution.

b. The non-refundable administrative fee (the California Community College per unit charge) is assessed and payable upon

program enrollment.

c. Additional fees (lab, materials, breakage, printing, etc) required of all other students will be required by the progra

parti

cipa

nt.

d. Aca

demic advising is only available at the program participants’ home institution.

e. Program participants are urged to secure approval from home institution advising in regards to course applicabil

ity to

gree requirements.

f. Program participants must meet the appropriate course prerequisites (the host institution will ch

eck).

g. The hom

e institution will provide a copy of ‘unofficial’ transcripts with the application to the host institutio

h. Fina

ncial aid is available only through program participants’ home institution (as program participants’ are required to be

enrolled in 12 or more units at the home institution, there is not a need for a financial aid consortium agreemen

t).

i. He

alth services at the host institution for program participants’ are limited to treatment for emergencies.

j. Students are only eligible for student services (i.e. career services, recreation center, housing, office of stud

ent

dis

abilities, etc.) at their home institution.

Parki

ng is available for a fee. Program participants’ should inquire with the respective host institution.

l. Program participants’ at UC Merced are required to purchase a CatCard at a cost of $20. The card is required to identify

the affiliation with the UC Merced and also allows for library and printing services

m. Stud

ents are subject to all administrative procedures of the respective host institution while they are visiting as a progra

parti

cipant, including the Student Conduct Code and requirements for course drops and changes, which may

acc

essed by inquiring at the administrative offices of either respective institutio

Speci

al Note for Potential Transfer Students:

California Community College (CCC) students should be advised that in order to maintain your standing as a CCC student for UC

Merced admissions purposes, you must have 30 out of your last 40 semester units at a CCC and you must be enrolled for at least two

regular terms at a CCC immediately prior to enrolling at UC Merced. Please contact UC Merced Transfer Student Services at (209)

228-4682 with any questions regarding this policy.

UC MERCED AND MERCED COLLEGE INTERSEGMENTAL CROSS-ENROLLMENT

Frequently Asked Questions

Who is eligible to participate?

• UC Merced and Merced College students who:

o have completed at least one term and at least 12 units of degree applicable work at their home

institution with at least a 2.0 cumulative grade point average.

o are enrolled in 12 units and have paid their tuition and fees at the home institution during the same

term they want to cross-enroll.

o who meet host institution prerequisites for the courses for which they want to cross-enroll.

o have not been academically disqualified from the host or the home institution.

o be a California resident for tuition purposes or be exempted from nonresident tuition to participate.

Students paying non-resident fees are not eligible to participate in the UCM and Merced College

Intersegmental Cross Enrollment Program.

How many courses may students take and are courses limited?

• Students may cross-enroll in one course per term.

• Course availability is subject to space availability, deadlines, registration procedures, and priorities of the home

and host institutions.

How much does cross-enrollment cost?

• A non-refundable fee is assessed and payable when students submit applications to cross-enroll. For 2008-

2009 this fee is $20 per unit (payable by cash, credit card, or check).

• Students must also pay any additional fees (lab, materials, breakage, printing, identification cards, etc.).

Can students use their financial aid to pay for cross-enrollment?

• Financial aid is available from the home institution only.

Are there additional costs if students are nonresidents?

• Students paying non-resident fees are not eligible to participate in the program.

What host institution services do cross-enrolled students receive?

• Students are eligible for student services at their home institution (for example, academic advising, career

services, recreation center, housing, etc.). Students will be able to access email and portal services at the host

institution.

• Parking is available for a fee and is payable to the host institution.

How do students get transcripts after the course is completed, and will the credit transfer to the

home institution?

• The host institution will send an official transcript to the home institution at the conclusion of the cross-enrolled

course. There is no transcript cost to the student.

• To ensure the course will apply to degree requirements, students must secure approval from their home

institution’s academic advisors before cross-enrollment.

Where can students obtain an application, and how can they get started?

• Applications for Cross-Enrollment are available at the home institution’s Registrar’s office.

(UC Merced: registrar.ucmerced.edu “Special Programs” Merced College: www.mccd.edu/ar/index.html)

• Cross-enrollment policies and procedures are listed on the reverse side of the application form.

What are the five steps that students should follow?

1. Obtain the application form at your home Registrar’s office.

2. Complete the form and meet with your academic advisor to obtain approval on the form.

3. Submit the form to the home Registrar’s office for a representative there to certify and attach your unofficial

transcript.

4. Obtain the instructor’s approval on the form when the term/course begins.

5. Submit the form, unofficial transcript, and payment to your host Registrar’s office, so a representative can check

prerequisites and enter the registration.