LLCC Office of Admissions 5250 Shepherd Road P.O. Box 19256 Springfield, IL 62794-9256 www.llcc.edu
Return completed form to:
Former LLCC students do not need to submit this form unless address, phone, major or academic history has changed since last enrollment.
Admissions Information Worksheet
Thank you for choosing Lincoln Land Community College. Lincoln Land Community College is an equal opportunity educator and employer.
Lincoln Land Community College commits to not discriminating against any student, employee, or prospective employee on the basis of race, sex, age, disability, creed, marital status, national origin, political affiliation or sexual orientation. Any violations of this policy should be reported to the Equal Opportunity Compliance Officer, Human Resources, Menard Hall, 217-786-2259.
BOARD OF TRUSTEES
Roger Rutherford, Chairman Andy Ramage, Vice Chairman Gordon A. Smith, Ed.D., Secretary Daniel Austin Cinda Edwards Kent Gray Carl Oblinger, Ph.D.
Lincoln Land Community College
Admissions Information Worksheet
Planned term of entry: Fall ____ Spring ____ Summer ____
res. oper.
Former LLCC students do not need to submit this form unless address, phone, major or academic history has changed since last enrollment.
Complete legal permanent address: street address, apt or P.O. box number ________________________________________________________________________________________
Complete legal name: Last______________________________________ First______________________________________ M.I.
____________
How long have you lived at the above address? ___________________ E-mail address:_________________________________________________ Phone: ___________________________________________home/cell/business (Please circle one) Social security number: _____________/_______/____________ K U. S. Citizen or K Resident Alien
(Note: Your SSN is protected under FERPA, Federal Guidelines and will not be released.)
Zip:_______________ City:___________________________________ State:_________________ County: ________________________________
Birth date (numbers please) _________/_______/________ K Male K Tourist Visa, valid until ______
K Female
K F-1 Student Visa, issued through ____________________ K Other Visa: _________________ Is English your primary language? K Yes
K Work Visa, valid until ______
K No
High school attended/attending:___________________________________________________________ Anticipated or actual H.S. grad. year______ K Asian or Pacific Islander - 01 K American Indian or Alaskan Native - 02 K African-American - 03 Ethnic origin, please check one: K Hispanic-American - 04 K White American, non-Hispanic - 06 K Nonresident alien - 07 K Prefer not to indicate - 08
Program/field of study. See “program guide,” select from listings on the following pages and write program code here:_______________ example: AS.ACCT Note: Students still in high school (pre-college) for another 1-2 years must list “undeclared” as major Educational goals, please circle one: 4. To prepare for the GED test or improve my basic academic skills. 5. For personal interest/self-development, not career-oriented. 6. Other
1. To prepare for transfer to a college or university. 2. To improve skills for my present job. 3. To prepare for a future job immediately after attending LLCC.
1. First time college 2. New, pre-college (still in high school another 1-3 years) Indicate highest degree earned, please circle one:
Admission status, please circle one:
Certificate, degree objective, please check one: _____Course(s) only _____Complete a certificate _____Complete an associate degree 3. Transfer to LLCC: previously attended another college 4. New general studies 5. Continuing - enrolled at LLCC last term 6. Moved to college level from other 7. Returning to LLCC - not enrolled last term
1. HS diploma 2. GED, date ________ 3. Some college
Have you ever been expelled or dismissed from any post-secondary institution for behavioral or disciplinary reasons? _____No _____Yes/Institution____________________________________________________________ Year__________ 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. Signature ___________________________________________________ Date _______________________________________________________ Applicant under 18 parent/guardian signature required ________________________________________ Date ______________________________
Has either of your parents attended college? K Yes K No Has either of your parents completed a four-year (bachelor’s) degree? K Yes K No Military status, please check one: K Active K Guard/Reserve K Veteran
4. Certificate 5. Associate 6. Baccalaureate
7. Master’s 8. Doctorate 9. Other
10. None 11. Still in high school (See Special Admissions)
PROGRAM GUIDE
Accounting - AS.ACCT Agriculture - AS.AGRI Architecture - AA.ARCH Art - AA.ART Biology - AS.BIOL Business Administration - AS.BUSAD Chemistry and Chemical Engineering - AS.CHEM Communications - AA.COM Computer Science - AS.CSCI Criminal Justice - AA.CRJ Pre-Dental - AS.PDEN
Associate in Arts (AA), Associate in Science (AS), or Associate in Arts in Teaching (AAT) Degree (Transfer)
Early Childhood Education - AA.ECHED Early Childhood Education - AAT.ECE Economics - AS.ECON Elementary Education - AA.ELED Foreign Language - AA.FORL Pre-Forensic Science - AS.PFSCI Geo Sciences - AS.GEOSC Graphic Design - AA.GRDSN History - AA.HIST Interpreter Training - AA.INTP Journalism - AA.JRNL Pre-Law - AA.PLAW Law Enforcement - AA.LAW Liberal Arts - AA.LBA Liberal Arts - AS.LBA Literature - AA.LIT Mathematics - AS.MATH Pre-Medical - AS.PMED Pre-Clinical Lab Science - AS.MEDT Music - AA.MUSC Pre-Pharmacy - AS.PPHAR Philosophy - AA.PHIL Physical Education - AS.PHED Physics - AS.PHYS
Political Science - AA.POSC Psychology - AA.PSYC Secondary Education - AA.SECED Sociology - AA.SOCL Special Education - AAT.SPCED Speech - AA.SPCH Theatre - AA.THEA Pre-Veterinary - AS.PVET Women’s Studies - AA.WMST
THE PROGRAMS LISTED IN THIS SECTION REQUIRE SPECIAL ADMISSIONS Please contact an Academic Advisor for information or refer to the current LLCC catalog.
Associate in Fine Arts (AFA) or an Associate in Engineering Science (AES) Degree (Transfer)
Associate in Engineering Science - AES.ENGR Associate in Fine Arts – Art - AFA.ART Associate in Fine Arts – Music Performance - AFA.MUSIC
Allied Health Programs (Career and Technical)
Associate Degree Nursing - AGE.PHLT1 Occupational Therapy Assistant - AGE.PHLT2 Associate Degree Radiography - AGE.PHLT3 Practical Nurse - CA.PHLT Electroneurodiagnostics - AGE.END Respiratory Care - AGE.RCP Nursing - AS.PNUR
Associate in Applied Science (AAS) Degree (Career and Technical)
Accounting - AAS.ACCT Administrative Assistant/Office Professional - AAS.ADMIN Agri-Business Management - AAS.AGBUS Airframe and Powerplant Aviation Mechanics AAS.AMECH Architectural and Construction Technology - AAS.ACT Auto Body Technology - AAS.ABODT Automotive Technology - AAS.ATEC Aviation Management - AAS.AMGMT Business - AAS.BMGT Commercial Electrical Maintenance - AAS.CEM Computer Information Systems/Networking - AAS.CISNT Computer InformationSystems/Programming - AAS.CISPR Construction Occupations - AAS.CONST Customized Applied Technology - AAS.CAPTC Early Childhood Education - AAS.CHDV Electrical Distribution Lineman - AAS.EDLM Electronics Technology - AAS.ETEC Fire Science Technology - AAS.FISCI Graphic Design Technology - AAS. GRDST Hospitality Management and Services - AAS.HMS Landscape Design/Turf Management - AAS.LDTM Law Enforcement - AAS.LAW Legal Office Assistant - AAS.LOA Medical Office Assistant - AAS.MOA Microcomputer Applications and Systems AAS.MSYS Microcomputer Programming - AAS.MPRG Networking Administration - AAS.NTWA Networking Techniacian - AAS.NWT Paraprofessional Education - AAS.PARED Precision Agronomy - AAS.AGFER Social and Criminal Justice -AAS.SCJ Structural Steel Detailing - AAS.STRSL
Associate in General Education (AGE) Degree (Non-Transferable)
Liberal Arts - AGE.LBA
Architecture and Construction - CA.ARTCN Automotive Technician - CA.AUT Aviation Airframe Technician - CA.ATECH Aviation Powerplant Technician - CA.PPTCH Child Development Aide - CA.CDV Construction Occupations - CA.CONST
Certificate of Achievement (more than 30 hours) (Career and Technical)
Culinary Arts - CA.FDBV Electrical Distribution Lineman Maintenance - CA.EDLMM Electronics Technology - CA.ETEC Emergency Medical Technician - Paramedic - CA.EMTP Entrepreneurship - CA.ENTPR Lodging Management - CA.HMMGT
Medical Coding Specialist - CA.CODE Networking Technician - CA.NWT Web Authoring and Design - CA.WEB Welding Specialist - CA.WELSP
PROGRAM GUIDE (continued on back)
PROGRAM GUIDE (continued)
Applied Security Practices - CC.SECU Auto Body Repair - CC.ABOD Baking and Pastry - CC.PSTRY Basic Computer Applications Skills - CC.BCAS Basic Nurse Assistant - CC.CNA CAD Technician - CC.CADT Certified Firefighter II - CC.FRFT Certified Firefighter III - CC.CFIII Certified Warehouse and Dist. Specialist - CWHDS Cisco Network Administration Training - CC.CISCO Commercial Electrical Maintenance - CC.CEM Community Police Officer - CC.CPO Computer Programming - CC.COMP Computer Technician Specialist - CC.CTECS Criminal Justice Studies - CC.CRJT E-Business - CC.EBUS Emergency Medical Technician- Basic - CC.EMTB Fire Apparatus Engineer - CC.FRAPE Personal Development - CC.PDEV
Certificate of Completion (30 hours or fewer) (Career and Technical)
Fire Investigator - CC.FRINV Fire Prevention Principles - CC.FRPRV Fire Service Instructor I - CC.FINI Fire Service Instructor II- CC.FINII Fire Tactics and Strategy I - CC.FTACT Haz. Materials for the First Responder - CC.HAZMT Heating, Ventilation, Air Conditioning, and Refrigeration - CC.ACRH Help Desk I - CC.HPDKI Help Desk II - CC.HPDK Internet Programming - CC.INPG Juvenile Firesetter Intervention Specialist - CC.JUVFS Landscape Design/Turf Mgmt.- CC.LDTM Leadership - CC.SUMA Legal Office Assistant - CC.LOA Management - CC.BGMT Medical Office Assistant - CC.MOA Medical Transcription - CC.MEDTR
Microcomputer Applications and Systems - CC.MSYS Microcomputer Programming - CC.MPRG Networking Administration - CC.NTWA Office Aide/Office Assistant - CC.OAOA Office Support Specialist - CC.OSS Real Estate Broker - CC.RLSTB Real Estate Salesperson- CC.RLSTS Rescue Confined Space - CC.RSCCS Rescue Specialist-Vertical Level I - CC.RSCSP Security Cert. Network Architect - CC.SCP Structural Collapse Operations - CC.STRCL Technical Rescue Awareness - CC.TCRSC Truck Driver Training CDL Basic - CC.TDSB Vehicle/Machinery Operations - CC.RDSP Welding Operator - CC.WEOP Welding Specialist - CC.WELSP Word Processing/Graphics Specialist - CC.WPGS
Certificate of Personal Development (Career and Technical) Undeclared Program - UNDECLARED Please note: “Undeclared” may make you ineligible for financial aid and the tuition tax credit (TR-97). Please consult your tax preparer for details and guidelines appropriate for you. College Knowledge If you plan to work toward a certificate or degree, ask your high school and any colleges you may have attended to send your final, end-of-year transcripts to the LLCC Admissions Office. Students needing financial assistance should apply as early as possible each year after January 1. If you need financial aid, visit the Financial Aid Office in Menard Hall or call 786-2237 to obtain the necessary application forms. The process takes several weeks, so be sure to apply for aid as soon as possible.
Home Schooled Students: Home schooled students interested ina single course to a degree are welcomed at Lincoln Land Community College. Home schooled students follow the admissions, placement, advising and enrollment procedures as all new students. Transcript records of home schooling are accepted. To insure accurate transcript evaluation, the student may be asked to meet with a Student Records Evaluator to review subject matter and course content. Academic Advisement and Career Counseling: The Student Services Center helps students explore career opportunities and select courses required to complete programs of choice. Academic advising is also available at all regional centers. Placement Testing: New degree/certificate seeking students may need assessment for proper course placement. Call 786-2211 for information.
Purchase Textbooks: Required and optional textbooks and supplies are available in the LLCC Bookstore or the regional centers. Most textbooks are available three to four weeks before the term begins. Or, order online at www.llccbookstore.com. For information, call 786-2300.
SOAR — Student Orientation Advising Registration: Prior to enrolling, degree-seeking students new to LLCC and transfer students with less than 15 credit hours need to complete a PC based orientation. This informational orientation to college services and procedures is available at all LLCC locations.
Students in this category are not considered degree or certificate seeking until completion of high school/GED. These students must list “undeclared” as a major until completion of high school/GED or past the age of compulsory attendance.
Phone Registration Tips: During peak registration the main line on campus experiences heavy usage. We recommend contacting a regional center. Regional center staff can register students for any class offered at any location.
SPECIAL ADMISSION OF STUDENTS UNDER THE AGE OF 18 Students aged 16-18 who have not yet graduated high school or achieved a GED and wish to enroll in college credit courses may do so following the same admissions, testing, advising and enrollment procedures as all students new to the college. This includes providing current high school/home schooled transcripts, meeting ACT/SAT or placement score requirements and course prerequisites. Main Campus East Springfield Eastern Region Southern Region Western Region Western Region Learning Center Education Center Education Center Education Center Education Center Taylorville 217-287-7081 or 1-800-572-5448 Litchfield 217-324-2090 or 1-800-858-9193 Jacksonville Beardstown 217-243-6699 or 217-323-4103 or 1-888-494-1622 1-877-800-4406
2/08 – 9/08 Edition
Springfield Springfield 217-786-2298 217-522-9205 1-800-727-4161 217-522-9047