Submit this form by mail or in person to: Enrollment Center

Oakton Community College

Room 1860, 1600 East Golf Road, Des Plaines, IL 60016

Room A100, 7701 North Lincoln Avenue, Skokie, IL 60077

If you are a first-time student at Oakton Community College, there is a one-time,non-refundable, $50 fee that will be added to your account within one business dayof submitting this form.

Checks should be made payable to Oakton Community College.

StudentAdmission

Application

International

PROGRAMS OF STUDY

*Limited Admission Program. Separate Health Care Career application required.

3/17

TRANSFER DEGREE PROGRAMS

0500 Business

0520 Elementary Education

0850 Engineering

0801 Fine Arts - Art

0802 Fine Arts - Music

0700 Liberal Arts

0650 Science or Mathematics

0540 Secondary Education

CAREER DEGREE PROGRAMS

0005 Accounting Associate A.A.S.

0060 Air Conditioning, Heating, and Refrigeration Technology A.A.S.

0031 Automotive Technology (Apprenticeship) A.A.S.(Call Michael Peat 847-635-1906 prior to applying.)

0301 Computer Applications for Business A.A.S.

0142 Computer Networking and Systems A.A.S.

0120 Computer Programmer A.A.S.

0121 Computers and Information Systems A.A.S.

0070 Early Childhood Education A.A.S.

0165 Electronics and Computer Technology A.A.S.

0362 Facilities Management A.A.S.

0363 Facilities Energy Systems Technology A.A.S.

0180 Fire Science Technology A.A.S.

0370 Graphic Design A.A.S.

0285 Health Information Technology A.A.S.*

0207 Human Services A.A.S.

0240 Law Enforcement A.A.S.

0226 Management and Supervision A.A.S.

0274 Manufacturing Technology A.A.S.

0265 Marketing Management A.A.S.

0270 Mechanical Design/CAD A.A.S.

0253 Mechatronics Technology A.A.S.

0280 Medical Laboratory Technology A.A.S.*

0148 Network Security Administration A.A.S.

0320 Nursing A.A.S.*

0340 Paralegal Studies A.A.S.

0360 Physical Therapist Assistant A.A.S.*

0204 Substance Abuse Counseling A.A.S.

Last high school you attended:

___________________________________________________________Name City State

Check one box that best describes your high school status:

� High school graduate in ________________ year

� Passed G.E.D. test ________________ year

� Withdrew from high school prior to graduation

College(s) or ESL school attended since high school graduation:

___________________________________________________________Name City State

___________________________________________________________Name City State

___________________________________________________________Name City State

Most credits or highest degree previously earned:

� Some credits � Associate’s degree � Master’s degree

� Certificate � Bachelor’s degree � Doctoral degree

I certify the above statements are complete and correct. I understand that if I withhold or give false information on this application it may make me ineligible for admission to the college or subject me to dismissal.

Applicant’s signature __________________________________________________________ Date _____________________________________

Write in the name and code number of your program/major from the Programs of Study listed on the opposite page. A separate application is required if applying to a limited admssion Health Career program.

Program/Major: Program/Major four-digit code number:

I am applying for (check one) : � Fall 20____ (Aug. - Dec.) � Spring 20____ (Jan. - May) � Summer 20____ (June - July)

I am a: � New college student with � Student with prior college credits � Former Oakton studentno prior college credits or degree returning to the College

Name _________________________________________________________________________(Complete legal name) Last First Middle Initial

Address ____________________________________________________________________________________________________________________Street Unit No. City State Postal Code Country

Telephone ______________________________________________________ ______________________________________________________Home Cell

Email ________________________________________________________________________

Social Security Number – – Gender � Male � Female

If you do not have a Social Security number, a Student ID number wil be assigned to you.

List any other names, such as a different last name, used previously to identify records you will be submitting to Oakton.

___________________________________________________________________________________________________________________________________Last First Middle Initial

What is your current immigration status in the U.S.A.? (Submit a photocopy of your documentation with this application)

� F-1 currently enrolled at another college/university � Visa and Type ___________________________ � Other _______________________________

INTERNATIONAL STUDENT APPLICATION FOR ADMISSIONPlease print in black ink only.

continued on back

Date of birth / / month day year

FOR OFFICE USE ONLY

Banner ID No. Initials/Date

Application accepted by Date Processed by: Date

Billing Status

Which statement most accurately reflects your objective at Oakton? (Check only one)

� Earn an associate degree (A.A., A.S., A.F.A. or A.S.E.) in a transfer program

� Earn an associate degree (A.A.S.) in a career program

� Earn a certificate (less than two years) in a career program

� Take some courses, but not earn a degree or certificate at Oakton

Which statement most accurately reflects your primary reason for attending Oakton now? (Check only one)

� a. Prepare for transfer to a four-year college/university � e. Remedy or review basic academic skills deficiencies

� b. Improve present occupational skills � f. Prepare for high school diploma equivalency

� c. Prepare for new or first career � g. Pursue non-degree personal interests

� d. Explore courses to decide on a career � h. Other

Do you plan to transfer to a four-year college or university? � Yes � No � Presently attending a four-year college or university.

At which Oakton campus do you plan to attend class(es)? � Des Plaines � Skokie � Not sure

Questions about applying to Oakton Community College?

Contact us at 847-635-1700, enrollment center@oakton.edu or go to our Web site, www.oakton.edu/admiss.

This information is requested solely to comply with Federal reporting requirements.

1. Are you Hispanic or Latino? (OR Are you of Spanish origin?) � Yes, Hispanic or Latino � Not Hispanic or Latino

2. Are you from one or more of the following racial groups? (Select all that apply).

� American Indian or Alaska Native � Asian � Black or African American � Native Hawaiian or Other Pacific Islander

� White � Choose Not to Respond

3. Please identify your primary racial/ethnic group. (Select one).

� American Indian or Alaska Native � Asian � Black or African American � Hispanic or Latino

� Native Hawaiian or Other Pacific Islander � White � Choose Not to Respond

4. Are you in the United States on a Visa – Nonresident Alien?

� Yes in the United States on a Visa. � Not in the United States on a Visa. Provide Home Country of Origin _____________________

Oakton Community College does not discriminate on the basis of race, color, creed, religion, national origin, disability, age, sex, sexual orientation or marital status in admissionto and participation in its education programs, College activities, services, or employment practices.The College does not tolerate sexual harassment or sexual assault by or of itsstudents or employees. In compliance with the Americans with Disabilities Act (ADA), which prohibits discrimination against persons with disabilities, Oakton Community College is committed to making all programs accessible and providing reasonable accommodations for persons with disabilities.

Students with disabilities may inquire about support services and accommodations by calling 847-635-1759. Persons who are deaf or hard of hearing

should call 1-800-526-0857 (Illinois Relay Center).