Online Student Information Form

    Personal Information

    Personal Information

    Name

    Name

    If you are a former student and/or applicant with a NAME CHANGE the Student Information Form will not be processed. You must come to the Admissions, Registration and Records Office to submit your Student Information Form along with legal documentation verifying the name change. If you have any questions concerning this matter please contact 815-825-2086 ext. 4190 or email arr@kishwaukeecollege.edu

    Former Name

     

    Permanent Address

    Permanent Address

    (include Apt. # or P.O. Box)

    City, State:*

      

    Local Address

    Local Address

    (include Apt. # or P.O. Box)

    City, State:

      

    E-mail

    E-mail

    Phone Numbers

    Phone Numbers

    Identification

    Identification

    Are you Hispanic or Latino?*

    Are you from one or more of the following racial groups?*
    Select All That Apply
    (PC: hold down Ctrl and select multiple options; Mac: hold down Command)

    Social Security Numbers are kept confidential and not released to any individual or organization except as required by federal and state laws. Applicants who do not have a Social Security Number will be assigned a Kishwaukee College student identification number. All financial aid applicants will be required to provide a social security number.

    Educational Information

    Educational Information

    Educational Purpose

    Educational Purpose

    Select the status that applies to the enrollment start term you selected above*: (admission status definitions)

    na

    *** Programs marked are NOT eligible for financial aid.

    Educational History

    Educational History

    You can enter up to five institutions, one of which can be a High School or GED. To add an institution, click the appropriate button ("Add High School/GED" or "Add College/University"), fill in the fields, and click "Add." The institution will be added to your admission form, and you are ready to add another.

    High School or Equivalent

    High School or Equivalent

    College/University Attended

    College/University Attended


    Twitter Facebook Youtube Foursquare

    Supporting our Veterans