CCP Authorization Form
Please complete the CCP Authorization Form on behalf of your student.

If you do not click Continue or Move to Draft within 2 hours, your data will be lost.

Attention!
If you do not click Continue or Move to Draft before the timer expires, your data will be lost.
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:
 
Counselor/Submitter Name:
 
I authorize the student to participate in the CCP program during the Academic Year:
 
Academic Year
 
Counselor/Submitter Email:
 
Counselor/Submitter Phone Number:
 
Additional Comments (Is there anything youd like us to know about this student?):