Application for Admission

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Full Name *

Address *

City *

State *

Zip *

Home Phone

Cell Phone *

Email Address *

Date of Birth *

Gender

Are you a US Citizen? *

Are you a Veteran? *

Country of Origin *

US Visa Type

Expiration Date

If U.S. Permanent Resident, indicate Alien Registration Number

Resident of the State of Illinois? *

If no, in what state do you reside?

The purpose of this request is solely for compliance with Federal Civil Rights Laws and ICCB mandate. Your response will not affect consideration of your application. By checking the following, you will help us to assure that students are served in a non-discriminatory manner. *

I understand

Ethnicity *

If Two or More Ethnicities Please Indicate

Highest Education level previously attained *

Online Or Campus Based Program? *

My intended Program of Study is *

Starting Semester *

Status *

Enrollment Status *

Did You Graduate High School/Obtain A GED? *

High School or County of GED Name *

High School or County of GED Date of Graduation/Completion *

Year

Month

Day

High School or County of GED City *

High School or County of GED State *

I previously attended another college or university *

If yes, name the most recent College or University attended

If yes, City and State of most recent College or University

If yes, Dates of Attendance to most recent College or University

List Any Additional Colleges or Universities that you have attended here:

Have you ever been charged or convicted for any violent crime in any state or country (unless expunged)? *

Have you ever been suspended, dismissed or expelled from any high school, college, or university or are you facing current disciplinary charges at any high school, college, or university? *

Do you intend to apply for financial aid at Generations? *

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relation

It is your responsibility to ensure that your application information and all supporting documentation is truthful, complete and correct. Generations College reserves the right to verify any information provided as part of this application. If any information in your application is determined to be false or misleading, concealed or withheld, your application may be invalidated and this could result in its immediate rejection or in the revocation of an offer of admission or registration at Generations College and forfeiture of all fees paid to Generations College. Under the Federal Educational Rights and Privacy Act (FERPA) all applications and transcripts issued to Generations College become property of the College. Some curricula have additional admission requirements. For more specific information, see the College catalog. *

I understand

You can find the FERPA Release Form by clicking here.

Electronic Signature *

Date of Signature *

Year

Month

Day

I give my authorization to release my high school and/or College transcripts to Generations College. *

I give my authorization to release my high school and/or College transcripts to Generations College.

I hereby authorize Generations College to use, reproduce, and/or publish photographs, and/or video that may pertain to me – including my image, likeness and/or voice without compensation. *

The Student Code of Conduct and other regulations listed in the E-Catalog are minimum behavioral standards for a successful college experience. I agree to follow these expectations during my enrollment at Generations College.

I understand *

I understand

Electronic Signature *

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Application for Admission