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CCIR Interest Form
Bettendorf High School helps prepare students for their futures by offering Certificate Programs, Associate of Arts Courses, and enrollment into Scott Community College's courses through Individual Registration (CCIR).

Potential enrollment in a course is determined by the following:

   - Attendance rate of 90% or better
   - Academic success (recommended C or higher grade in prerequisite courses),
   - 2.75 GPA
   - Must have access to transportation in order to get to and from Scott community College

Mandatory PRIDE will be May 27th in the Career Center
For more information please contact your counselor.
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Untitled Title
School Email Address: *
Student ID Number: *
First Name: *
Last Name *
Which of the following FALL classes would you be interested in taking during the 2025-2026 school year if your schedule allows? See course descriptions here: http://catalog.eicc.edu/content.php?catoid=5&navoid=150 Additionally, completing this form does not mean you are enrolled in the course. You will receive a packet of information after completing this form. *
Required
Which of the following SPRING classes would you be interested in taking during the 2025-2026 school year if your schedule allows? See course descriptions here: http://catalog.eicc.edu/content.php?catoid=5&navoid=150 Additionally, completing this form does not mean you are enrolled in the course. You will receive a packet of information after completing this form. *
Required
By clicking yes, I understand that if I enroll in a CCIR course I will need to provide my own transportation to the Scott Community College location where the class is being held.
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