Application for Admission

Full Name *

Address *

City *

State *

Zip *

Home Phone

Cell Phone *

Email Address *

Date of Birth *

Age *

Male or Female *

Male

Female

Are you a US Citizen? *

Yes

No

Are you a Veteran? *

Yes

No

Country of Origin *

US Visa Type

Expiration Date

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

Resident of the State of Illinois? *

Yes

No

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 *

Highest Education level previously attained *

My intended Program of Study is *

How did you first learn about Generations College *

Transfer plans *

I plan to transfer to a four-year college

I do not plan to transfer to another four-year college/university

Starting Semester *

Status *

Full-Time

Part-Time

Enrollment Status *

High School or County of GED Name *

High School or County of GED City *

High School or County of GED State *

I previously attended another college or university *

Yes

No

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)? *

Yes

No

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? *

Yes

No

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

Yes

No

Emergency Contact Phone Number

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 the Generations College and forfeiture of all fees paid to Generations College. I understand the applicant is responsible for presenting all materials to the Office of Admissions, Generations College, Chicago, IL 60602. 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 hereby authorize the release of my transcript(s) by the high school and/or colleges listed above. *

I understand

Electronic Signature *

Date of Signature *

Year

Month

Day

Please Note: Generations College does not discriminate on the basis of race, ethnicity, color, age, sex, national origin, or disability in administration of its educational policies, admission policies, loan programs, placement services, and other school administered programs. At Generations College we respect your privacy. Any information you provide to us will be used solely for admissions purposes. If you have a documented disability and require services and/or accommodations, please contact the Admissions Counseling Department at 312-922-1884 for more information. *

I understand

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