Middle School Special Enrollment Petition

(For grades 6-8)


Middle School Special Enrollment provides enrichment opportunities for gifted middle school students who can benefit from college level instruction. Special part-time enrolled middle school students may enroll for one academic course each semester and are exempt from paying the California Community College enrollment fees. Middle school students are still required to pay the student representation fee, the student health fee, course fees, and to purchase their own textbooks as recommended or required for their college courses. Some courses may require payment of a material fee (see course description in class schedule).

This form must be submitted at least two weeks prior to the start of each semester. Upon submission, the Director of Admissions and Records will schedule an interview with the student and make a decision on a case-by-case basis.

Student Information

Please enter your student ID number. Numbers only. NO DASHES
Student's Name*
Student's Birthdate*
Student's Address*
Parent or Guardian's Name*

Course Information

(One academic course only) Example: Math 10
(Found in the schedule of classes) Example: 4636
Are there prerequisites for the course?*
Example: Math 155

Student must complete and provide the following when submitting this form:

  1. Complete and online Application for Admission with CCCApply: https://admissions.santarosa.edu/middle-school-and-application-minors 
  2. Attach a scanned letter of recommendation to support student's enrollment at SRJC. This letter should be written by your school principal and/or counselor on official school letterhead, and should verify an exceptional need. The letter should include the name of the SRJC course the principal or counselor approves the student to take (example: English 1A).
  3. Attach a scanned copy of most recent test scores, report card and/or transcript.
Has the student submitted an application for the semester they wish to take the course?*
Is the student homeschooled?*

PLEASE NOTE:   A&R will not be able to process your petition to enroll as a middle school student until you have submitted an application. Apply online first before submitting this form at: https://admissions.santarosa.edu/home-school-students-enrolled-high-school 

No File Chosen
File uploads may not work on some mobile devices.
PDF or image files ONLY. Word document attachments are not accepted.
No File Chosen
File uploads may not work on some mobile devices.
PDF or image files ONLY. Word document attachments are not accepted.
No File Chosen
File uploads may not work on some mobile devices.
PDF or image files ONLY. Word document attachments are not accepted.

Please read the following enrollment requirements for middle school students:

Special Admit Enrollment

  • Section 48800 of the California Education Code allows the governing board of any school district to determine which students would benefit from advanced scholastic or vocational work. The intent of this section of the California Education Code is to provide educational enrichment opportunities for a limited number of eligible pupils, rather than reduce current course requirements of elementary and secondary schools.
  • Middle school students may NOT enroll in English 300 level courses regardless of assessment results.
  • Santa Rosa Junior College reserves the right to exclude or limit enrollment of special admit students into impacted programs and other programs or courses based on health, safety, instructional methodology, faculty constraints, or legal requirements.
  • All middle school students must submit an SRJC application every spring or summer/fall semester in order for this form to be processed.

Student Responsibilities

  • Students may register for approved courses as recommended by the middle school counselor and principal after approval from the SRJC A&R Director.
  • All coursework taken at SRJC becomes a permanent part of the student's college academic history. Grades received or excessive drops have implications for future status involving financial assistance, athletic eligibility, academic standing, etc.
  • Students must file for prerequisites and arrange for testing, if necessary.
  • Students are responsible for reviewing and abiding by all academic and student policies in the Schedule of Classes and the College Catalog.
  • Students are required to meet all academic deadlines.
  • Middle school (Special Admit) students are exempt from enrollment fees. However, Middle school students must pay the student representation fee, the student health fee, and any course fees. Please see the Schedule of Classes for more information.
  • SRJC is an adult academic learning environment and all students are expected to behave accordingly.
  • By signing and submitting this form the student agrees that they are eligible to enroll as a middle school (Special Admit) student and will abide by all SRJC policies and procedures. Additionally, students agree that they have reviewed these expectations with their parent or guardian.

Parent or Guardian Information

  • Special Admit students are treated like every other college student. All college coursework is governed by the Family Educational Rights and Privacy Act (FERPA) which allows release of academic information, including grades, to the student only – regardless of age. Academic information is not released to parents or third parties without written consent of the student. Upon consent by the student, information is only released to the authorized party in person or in writing.
  • SRJC Admissions and Records Office does not keep daily attendance records for students. Parents should not contact college offices or instructors with the expectation of accessing their student’s attendance or other information.
  • Please be aware that all coursework at SRJC becomes a permanent record on the student’s academic college history; grades received or excessive drops have implications for future student status at the college, including financial assistance, athletic eligibility, etc.

By entering a college environment, the student will be exposed to a diverse population in education programs designed for an adult learner that may involve sensitive topics that might be considered controversial or offensive in the secondary setting. SRJC will not change course content or curriculum to accommodate Middle School (Special Admit) students.

By signing this document I agree to the following: I am the parent or legal guardian of the above named student. I acknowledge that my child, as a college student, will be expected to adhere to all college rules of conduct, as well as the expectations and responsibilities detailed on the back of this form. I understand that in accordance with State and Federal law, I will not have the right to access my child’s records without his/her written consent or court order. I understand that SRJC reserves the right to deny admissions to specific courses. I give permission for emergency first aid treatment for my minor child/legal ward. I also give my permission for him/her to be treated by a nurse, physician and/or mental health counselor in the Student Health Center at SRJC.
By signing this document I agree to the following: I have read the (Special Admit) Expectations and Responsibilities and agree to abide by them. I also understand that I must submit an online SRJC application for every spring or summer/fall semester in order for this form to be processed (www.santarosa.edu/apply). Further, by signing this form I authorize Santa Rosa Junior College (SRJC) to release my educational records to my middle school after each semester that I attend SRJC as a middle school student.
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