Application To Attend A Recognized

Illinois Public Community College

TO: Rend Lake College
District #521
Ina, IL 62846

Please fill this application out if you reside in Rend Lake College’s district.

EXAMPLE: I live in Rend Lake College’s district, but I would like to attend John A. Logan for a program that Rend Lake College does not offer.

For more information, please view this Document First Name Last Name City State Zip SSN - - Phone #
Format: xxx-xxx-xxxx
I hereby certify that I reside within Rend Lake
College District No. 521 and make application to attend a recognized Illinois
public community college.

I certify that I intend to enroll as a student in the
Curriculum College, beginning At date selector (semester/year) date selector and ending (semester/year) Email Mailing Address Notes / Comments:

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