Admissions Information Worksheet

If you are a new student (including new transfer), you must complete this Admissions Information Worksheet before registering for classes. There is no charge for the admission process.

If you are a current or returning student, you do not need to submit another admissions application unless your address, phone or other information has changed.

Fields marked with an asterisk (Required) are required.

RequiredPlease answer.

RequiredPlease tell us when you plan to start.

Complete legal name:

RequiredPlease enter your last name.You must enter at least 1 letter for your last name.Your last name cannot have more than 25 letters. RequiredPlease enter your first name.You must enter at least 1 letter for your first name.Your first name cannot have more than 20 letters.

Complete legal permanent address:

RequiredPlease enter your legal address.This field cannot be blank.Address cannot be longer than 75 characters.

RequiredPlease enter your zip code.Please enter your 5-digit zip code. RequiredPlease enter your city or town. State:Required

RequiredPlease select an answer.

Invalid format for email address.

RequiredPlease enter your phone number.Please enter phone number like this: (XXX) XXX-XXXX. RequiredPlease tell us if this is your home, cell or work number.

Emergency contact information:

Please enter the first and last name of your emergency contact.Please enter the first and last name of your emergency contact.You have entered too many letters, please fix. A value is required.Invalid format.

Please enter your SSN like this: XXX-XX-XXXXYour SSN is required! Due to federal tax requirements, your SSN is required. Your SSN will not be printed on any LLCC-issued documents except the 1098-T tax form.

Please enter your birth date.RequiredEnter birth date in this format: mm/dd/yyyy.Your birth date must be between 1913-2000.Your birth date must be between 1913-2000.

RequiredPlease select an answer.

RequiredPlease select one.

RequiredEnter 4-digit year.Year must be 4 digits.Year must be 4 digits.Graduation year must be between 1930-2017.Graduation year must be between 1930-2017.

RequiredPlease select an answer.

Use the 'CTRL' key to select more than one.

Program or field of study: Please select your program/field of study here. NOTE: Students who are still in high school ("pre-college") for another 1-2 years MUST select "UNDECLARED" as their 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).

RequiredPlease select a program of study.

RequiredPlease select your educational goal.

RequiredPlease select your certificate or degree objective.

RequiredPlease indicate your admission status.

RequiredWhat is the highest degree you have earned?

RequiredPlease select an answer.

RequiredPlease provide an answer.

RequiredPlease select an answer.

RequiredPlease select an answer.

RequiredPlease select an answer.

RequiredPlease select an answer.

I understand that withholding information requested on this worksheet or giving false information may make me ineligible for admission to the college or subject to dismissal. I certify that the above statements are correct and complete. I agree to abide by the rules and regulations of Lincoln Land Community College.

Please enter your name.

IMPORTANT: Clicking the "Submit My Application" button will submit your application and then redirect you to detailed information on important enrollment procedures. This will be your only notice of your responsibilities and the next steps in your enrollment process.

Click the "Submit My Application" button only once. It may take 1 or 2 minutes while your application is being processed. If you are unable to submit your application, please scroll to the top and make sure you have filled out ALL required fields!