Submit this form by mail, fax, or in person to: Enrollment CenterOakton Community CollegeRoom 1860, 1600 East Golf Road, Des Plaines, IL 60016Room A100, 7701 North Lincoln Avenue, Skokie, IL 60077Fax 847-635-1706

You may also apply online at www.oakton.edu/apply.

If you are a first-time student at Oakton Community College, there is a one-time,non-refundable, $25 fee that will be added to your account within one business day ofsubmitting this form.

Checks should be made payable to Oakton Community College. Student will receive an acceptance letter by mail.

StudentAdmissionForm

CAREER DEGREE PROGRAMS0005 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.

CAREER CERTIFICATE PROGRAMSAccounting0003 Accounting Associate Cert.0004 Accounting Technology Cert.0007 Income Tax Preparation Cert.0006 Professional Accounting - CPA Preparation Cert.

Air Conditioning, Heating and RefrigerationTechnology0058 Commercial Buildings Energy Systems Cert.0063 Residential Comfort Control Cert.0066 Residential Comfort Systems Installer Cert.0067 Stationary Engineer License Preparation Cert.

Applied Business0252 Applied Business Cert.0251 Customer Service Cert.**

Automotive Technology (Apprenticeship)0030 Automotive Technology (Apprenticeship) Cert.0032 Automotive Technology Powertrain Cert.

Computer Applications for Business0307 Administrative Assistant Cert.0311 Creative Software Advanced Cert.0310 Creative Software Specialist Cert.**0313 Creative Software User Cert.**0233 Executive Administrative Professional Cert.0312 General Office Cert.**0133 Microsoft Office Advanced Specialist Cert.0306 Microsoft Office Specialist Cert.0309 Microsoft Office User Cert.**0308 Office Assistant Cert.

Computer Information Systems0461 Advanced Web Site Developer Cert.0124 Computer Programmer Cert.0132 Computer Technology Cert.0125 Computer User Cert.0123 Digital ERP Using SAP Cert.**0118 General Programmer Cert.0137 Internet and Computer Core (IC3) Cert.**0145 Management of Information Systems (MIS) Cert.0147 Microsoft Project Management Preparation Cert.**0139 Oracle Database Administrator (DBA) Cert.**0127 PC Support Specialist Cert.0154 Linux Cert.**0460 Web Site Support and Maintenance Cert.0463 Web Site Developer Cert.

Computer Networking and Systems0170 Cisco Certified Network Associate (CCNA) Cert.0151 Network Security Cert.**0152 Network Security Administrator Cert.0122 Windows Desktop Support Technician Cert.**0128 Windows Server Administration Cert.0153 Windows Support Technician Cert.

Early Childhood Education0069 Advanced Early Childhood Education Cert.0073 Advanced Infant Toddler Cert.0068 Basic Early Childhood Education Cert.0074 Basic Infant Toddlers Cert.0076 Early Childhood Education Administration Cert.0077 Basic Family Child Care Provider Cert.0078 Advanced Family Child Care Provider Cert.

Electronics and Computer Technology0169 A+ Computer Diagnostic Specialist Cert.**0161 Home/Office Technology Integrator Cert.**0166 Electronics Technology Cert.0167 Electronics Computer Technician Cert.0176 Transportation, Warehousing, and Logistics Cert.**

Facilities Management and Engineering0368 Facilities Management Cert.0369 Facilities Energy Systems Technology Cert.

Financial Services0014 Financial Services/Investment Analysis Cert.**

Fire Science Technology0183 Basics of Fire Fighting Cert.**0181 Fire Science Technology Cert.0182 Emergency Medical Technician-Paramedic Cert.**

Global Business Studies 0202 Global Business Cert.**0203 Global Business Technical Cert.**

Graphic Design0371 Animation and Multimedia Cert.0372 Web Graphic Page Design Cert.0373 Photography Cert.

Health Information Technology0288 Medical Billing and Coding Cert.*

Horticultural Therapy0412 Horticultural Therapy Cert.* **

Human Services0209 Human Services Cert.

Law Enforcement0241 Law Enforcement Cert.

Management and Supervision0231 Business Security Management Cert.0235 Human Resource Specialist Cert.0223 Leadership Excellence Cert.**0224 Organization Management Cert.

Manufacturing Technology0276 Automation and Controls Cert.**0277 CNC/CAM Programming Cert.**0279 CNC Operations and Programming

Preparation Cert.**0271 Manufacturing Technology Cert.0264 Mechatronics Supply Chain Technician Cert.**

0254 Mechatronics Technology Cert.

Marketing Management0446 Marketing Communications Cert.0444 Marketing Management Cert.

Mechanical Design/CAD0267 CAD Interior Design Cert.**0273 Computer-Aided Design Cert.**0284 General Design Cert.0278 Industrial Design Engineering Cert.**0272 Mechanical Design/CAD Cert.0259 Revit – Building Information Modeling (BIM)

Cert.**0261 SolidWorks Cert.**

Medical Assistant0329 Medical Assistant Cert.*

Nanotechnology0195 Nanotechnology Cert.

Nursing, Basic Nurse Assistant Training0037 Basic Nurse Assistant Training Cert.**(Call Donna Dickson 847-635-1461 prior to applying.)

Nursing, Person-Centered Elder Support 0034 Person-Centered Elder Support Cert.**

Paralegal Studies0341 Paralegal Studies Cert.

Pharmacy Technician0282 Pharmacy Technician Cert.

Phlebotomy0281 Phlebotomy Cert.*

Substance Abuse Counseling0212 Advanced Substance Abuse Counseling Cert.0211 Preparatory Substance Abuse Counseling Cert.

Technical Communication0238 Technical Communication Cert.

PROGRAMS OF STUDY

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

**Program not eligible for financial assistance.3/17

TRANSFER DEGREE PROGRAMS0500 Business0520 Elementary Education0850 Engineering0801 Fine Arts - Art0802 Fine Arts - Music0700 Liberal Arts0650 Science or Mathematics0540 Secondary Education0701 Undecided**

Last high school attended:

Name City State

Check one box that best describes your high school status:

� High school graduate or expected date of graduation:

_______________ month_____________ year

� Passed G.E.D. test _______________ year

� Withdrew from high school prior to graduation

Colleges 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

Name _________________________________________________________________________(Complete legal name) Last First Middle Initial

Address ____________________________________ ________ __________________________________ _________________ ____________Permanent legal address Apt./Unit No. City State/Zip Code County

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

To be eligible for in-district tuition, you must show that you live in-district at least 30 days prior to the date the semester begins by

presenting one of the following: a valid Illinois driver’s license, an Illinois state ID, two current bank statements or utility bills or an

in-district high school transcript issued within the last two years.

Telephone ________________________________ ________________________________ Cell phone _____________________________________Home Business

E-mail _____________________________________________________________________ Gender � Male � Female

Social Security Number – –

Provide your Social Security number (SSN) or your Tax Identification Number (TIN), if one was assigned by the IRS. If you do not have a SSN or TIN, you may still complete this application and enroll in Oakton courses—please leave the field blank. The SSN/TIN are used to meet federal reporting requirements. All Oakton students areassigned a unique Student ID number to identify their Oakton student records.

Veteran �Yes � No If yes, list branch of service: ________________________________________

Are you a U.S. citizen? �Yes � No If no, what is your status in the U.S.? � Amnesty, Parolee, or Refugee

� Green Card Holder � I-20 (F-1 Visa) applicant � Visa and Type _______________________________________ � Other _____________________

Term: � Fall 20_____ (Aug. - Dec.) � Spring 20_____ (Jan. - May) � Summer 20_____ (June - July)(check one)

I am a: � New college student with � Student with prior college credits � Former Oakton student � Summer only (plan to transfer credit no prior college credits or degree returning to the College to home institution)

STUDENT ADMISSION FORMPlease print information.

Date of birth / / month day year

To attend: � Full-time (12 credit hrs. or more)(check one) � Part-time (less than12 credit hrs.)

Note: A separate application is required if applying to a limited admssion Health Care Career program.

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

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).

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 _____________________

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

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

� Earn an associate degree (A.A., A.S., A.F.A., or A.S.E.) in a transfer degree program. (Select a Transfer Degree Program from PROGRAMS OF STUDY list.)

� Earn an associate degree (A.A.S.) in a career degree program. (Select a Career Degree Program from PROGRAMS OF STUDY list.)

� Earn a certificate (less than two years) in a career certificate program. (Select a Career Certificate Program from PROGRAMS OF STUDY list.)

� Take some courses, but not earn a degree or certificate at Oakton. (Select any program from PROGRAMS OF STUDY list.)

Program/Major Choice: (Choose from Transfer Degree Programs or Career Programs of Study list)

___________________________________________________________________________ Program/Major four-digit code ______________________

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.

Student signature _______________________________________________________ Date _________________________________________

By submitting this application, you authorize Oakton Community College and those acting on its behalf to copyright, publish, and use audio, photographs, video, andother recordings or representations of you for promotional and educational purposes. You release and discharge the Oakton Community College Board of Trustees andthose acting on its behalf from any liability arising from such use. If for any reason you would like to opt out, please contact College Advancement at 847-635-1806.