For Dual Enrollment and Traditional Students Under the Age of 18
This form must be completed by a parent or legal guardian for any student under 18 years of age at the time of submitting their application for admission to Germanna Community College, including both Dual Enrollment and Traditional students.

We have reviewed the Application for Admissions and established that your student was under the age of 18 years old when it was submitted. While we have their electronic signature on file, a parent or legal guardian will also need to sign below. A copy of the application is available upon the student’s request.

I hereby certify that the information provided on this form regarding the above-named student is true, complete, and accurate to the best of my knowledge. I acknowledge and accept that, as the parent or legal guardian, I bear financial responsibility for any and all charges or financial obligations incurred by the student while they are a minor.

Parent or Legal Guardian's Name (Please type): Typed parent or legal gaurdian name is Required

Parent or Legal Guardian's Mailing Address:

Parent or Legal Guardian's Signature (Please type): Typed parent or legal gaurdian signature is Required

Date Parent signature date required