Early College High School Pathway Registration Form

Quincy College, 2024– 2025

As a new Early College High School (ECHS) Pathway student you are eligible to earn three (3) to four (4) credits this year. You are being asked to complete this form in order to create a student record at Quincy College so that your college credits can be tracked. At the completion of the ECHS Pathway you will be eligible to receive your Quincy College transcript that will show all Quincy College credits that you have earned.

Should you have any questions about this registration form, please contact your ECHS College Transition Coach:

North Quincy High School

Daniel Gould, danielgould@quincypublicschools.com

Quincy High School

Eli Stewart, elyjahstewart@quincypublicschools.com

We look forward to working with you this year!

Contact Information

First Name

Last Name

Suffix

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone Number

May we send text messages about Quincy College to your cell phone?

Mobile Phone

Email Address

Confirm Email Address

Birth Date

Gender

Citizenship Information

SSN

Race Information

Race (Choose one or more)

Ethnicity

Parent/Legal Guardian Information

Primary Parent/Legal Guardian First Name

Primary Parent/Legal Guardian Last Name

Primary Parent/Legal Guardian Address Line 1

City

State

Zip Code

Mobile Phone

Primary Phone Number

Parent Email Address

Second Parent/Legal Guardian First Name

Second Parent/Legal Guardian Last Name

Course Registration/High School Information

Should you have any questions about the dual enrollment course offerings at your high school, please contact your guidance/school counselor.

School

High School Student ID Number:

Grade

Graduation Year

If Other, please enter date of intended graduation here:

9th Grade Classes 

10th Grade Classes 

11th Grade Classes 

12th Grade Classes 

Parent/Legal Guardian Acknowledgement

As the Parent/Legal Guardian of this student, I confirm that I have reviewed and understand the agreement with Quincy College and approve of the student participating in this program.

Parent/Legal Guardian Name

Student Acknowledgement

I confirm that I have reviewed and understand the program expectations with Quincy College and meet all requirements to participate.

Student Name