Student Request to Enroll at Another College

Request to Enroll at Another College
CONCURRENT ENROLLMENT (Concurrent enrollment at both Palm Beach State AND another college)TRANSIENT STUDENT (Enrolled only at another college for one term, planning to return to Palm Beach State)
Students requesting study at a Florida public institution must process the form online at Floridashines.org if the receiving institution participates.
Name*

First NameLast Name
Email*
student@my.pbsc.edu
Student ID*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
This form will authorize the above student who is currently enrolled at Palm Beach State College to also enroll at:*
(Regionally Accredited College or University)
FallSummer ASpringSummer B
Term Year*
Course(s)*
Please briefly state the reason for the above request.*
Florida ResidentNon-Florida Resident
Academic Advisor's Email Address*
advisor@pbsc.edu
Please note:
1. Fifteen (15) semester hours toward a degree must be earned in residence at Palm Beach State.
2. If the request is granted, the approval is only for the specific institution, course(s), and term(s) listed above.
3. The course(s) will be evaluated under Palm Beach State's standard policy.
4. Official transcripts of the above course work must be sent to the Palm Beach State Registrar's Office immediately upon completion.
5. Unless otherwise noted, this student is eligible to return to Palm Beach State.
Should be Empty: