CCP Authorization Form
Please complete the CCP Authorization Form on behalf of your student. This form is required for students taking courses offered on our campus or online. Students who are ONLY taking courses offered in your building are NOT required to have this form completed on their behalf. If you do not click Preview & Confirm or Save & Submit Later within 2 hours, your data will be lost.
Attention!
If you do not click Preview & Confirm or Save & Submit Later before the timer expires, your data will be lost.
note image Fields with * are required.
Student First Name:
Student Last Name:
 
School Name:
Students anticipated graduation year:
 
Students SSID #: Home and Private School students: Please enter SEEDAN in this field.
 
ACT/SAT Scores (if any):
Has the student completed either of the following with a B average or better?:
 
Algebra II:
2 Units of English/Language Arts:
 
I authorize the student to participate in the CCP program during the 21/22 Academic Year:
 
Counselor/Submitter Name:
 
Counselor/Submitter Email:
 
Counselor/Submitter Phone Number:
 
Additional Comments (Is there anything youd like us to know about this student?):