F-1 Student LLCC Application

Planned term of entry (required): Fall Spring Summer Select entry term.

Complete legal name (required):

Last: Enter your last name. First: Enter your first name. M.I.:

Complete legal permanent address (required):

Street address, apt or P.O. box number:
Enter your address.

Postal Code: City: Enter your city.

Region: Country:

How long have you lived at the above address?

Email: Please enter a valid email address.

Phone: Home Cell Work

Birth date (required)(mm/dd/yyyy): Enter your birth date mm/dd/yyyy.Birth date must be entered as mm/dd/yyyy. Male Female

High school attended/attending:

Graduation year:

Do you consider yourself to be Hispanic or Latino? Yes No

Please select one or more of the following racial categories to describe yourself:

American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Choose not to respond

Program/field of study: Select your program of study here. Note: Students still in high school (pre-college) for another 1-2 years must select "UNDECLARED" as major.

Transfer degrees: Associate in Arts (AA), Associate in Science (AS), Associate in Arts in Teaching (AAT), Associate in Fine Arts (AFA) and Associate in Enginnering Science (AES).
These programs require special admissions, please contact an Academic Advisor for information: Accelerated Associate in Arts Degree (ASAP), Associate in Fine Arts (AFA), Associate in Engineering Science (AES) and Allied Health Programs (Career and Technical).
Non-transfer, Career and Technical degrees: Associate in Applied Science (AAS) Degree (Career and Technical). Associate in General Education (AGE) Degree (Non-Transferable).
Certificates (Career and Technical): Certificate of Achievement (CA) (more than 30 hours), Certificate of Completion (CC) (30 hours or fewer).

Education goals, please select one:

To prepare for transfer to a college or university
To improve skills for my present job
To prepare for a future job immediately after attending LLCC
To prepare for the GED test or improve my basic academic skills
For personal interest/self-development
Other

Certificate, degree objective, please select one:

Course(s) only Complete a certificate Complete an associate degree

Admission status, please select one:

First time college
New, pre-college (still in high school another 1-3 years)
Transfer to LLCC, previously attended another college
New, general studies
Continuing, enrolled at LLCC last term
Advanced from adult education to college level
Returning to LLCC - not enrolled last term

Indicate highest degree earned (select one):

HS diploma GED Some college Certificate Associate
Baccalaureate Master's Doctorate Other None
Still in high school

Military status, please check one: Active Guard/Reserve Veteran

Has either of your parents attended college? Yes No

Has either of your parents completed a four-year (bachelor's) degree?

Yes No

Please select your primary racial/ethnic group:

American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Choose not to respond

Is English your primary language? Yes No

IMPORTANT: Clicking 'Submit Admissions Worksheet' will redirect you to detailed information on important enrollment procedures. This will be your only notice of your responsibilities and next steps in your enrollment process.

If you are not redirected to the 'Enrollment Procedures' page please scroll to the top of this form and verify that you have completed all required fields. If you are still having problems call LLCC Admissions 217-786-2298 ex:5