You must have JavaScript enabled to use this form. Full Name * Address * City * State * Zip * Home Phone Cell Phone * Email Address * Date of Birth * Gender - None -FemaleMaleOther Are you a US Citizen? * - Select -YesNo Are you a Veteran? * - Select -YesNo Country of Origin * US Visa Type Expiration Date If U.S. Permanent Resident, indicate Alien Registration Number Resident of the State of Illinois? * - Select -YesNo 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 * - Select -Hispanic/LatinoAmerican Indian or Alaska NativeBlack or African AmericanWhiteNative Hawaiian or Other Pacific IslanderAsianTwo or More RacesRace/Ethnicity Unknown If Two or More Ethnicities Please Indicate Highest Education level previously attained * - Select -Doctoral DegreeMaster's DegreeBachelor's DegreeAssociate DegreeSome CollegeHigh School DiplomaGEDOther Online Or Campus Based Program? * - Select -OnlineCampus My intended Program of Study is * - Select -AS - Business AdministrationAS - EntrepreneurshipAS - Criminal JusticeAS - Paralegal StudiesAAS - Paralegal StudiesAAS - Court Reporting Starting Semester * - Select -Spring Semester 2024Summer Semester 2024Fall Semester 2024Undecided Status * - Select -Full-TimePart-Time Enrollment Status * - Select -First Time Freshman (never attended college)Transfer StudentAdvance Degree Student (Bachelor Degree or higher)Currently a High School Student Did You Graduate High School/Obtain A GED? * - Select -YesNo High School or County of GED Name * High School or County of GED Date of Graduation/Completion * Year Year197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 High School or County of GED City * High School or County of GED State * I previously attended another college or university * - Select -YesNo 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)? * - Select -YesNo 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? * - Select -YesNo Do you intend to apply for financial aid at Generations? * - Select -YesNo 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 Year202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 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. * - Select -YesNo 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 * Leave this field blank