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LCC > Student and Academic Support Division >

Application for Selective Admission Programs

Note:  All applicants must complete a General Admission Application (see General Admission Application Procedures) prior to completing this application. To receive specific program admission requirements contact Enrollment Services Office at (517) 483-1200 and it will be sent immediately.

- FILL IN ALL APPLICABLE INFORMATION
- VERIFY that all information is correct and free of typographical errors
- PRINT OUT THE COMPLETED FORM (including a copy for your records)
- RETURN  IT TO:

Lansing Community College
1121 - Enrollment Services Office
PO Box 40010, Lansing, MI
48901-7210
Phone: (517) 483-1200
Fax: (517) 483-9668

We will attempt to process your application within one week of submission but may take longer during busy times. If you are taking Online Courses (Online Learning), you will be able to continue with the pre-course activities and registration process after you are admitted.

Social Security Number

Last Name

 

First Name

 

Middle

 
(include apartment number, if any)

Present Address

City

State

Zip Code

Telephone (###-###-####)
or 



E-mail Address 
 
(include apartment number, if any)

Permanent Address

(where your mail can be forwarded, if different from above )

City

State
 

Zip Code

Telephone (###-###-####)

or 

 




A.   Curriculum code and Program choice:
(Please select one curriculum code.  A separate application must be completed for each program applied for.)

0738  Applicant to Criminal Justice, Mid-Michigan Police Academy

0209  Applicant to Dental Hygienist Program

0792  Applicant to Diagnostic Medical Sonography Program

0719  Applicant to Fire Academy

0925  Applicant to Histologic Technology Program

0231  Applicant to Career Ladder Nursing Program

0231 Applicant to LPN/ Paramedic to RN Completion Program

0722  Applicant to Music Commercial Performance Program

0830 Applicant to Sacred Music

0862  Applicant to Music Management Program

0721  Applicant to Music Transfer Program

0223  Applicant to Paramedic Program

0198  Applicant to Radiologic Technology

0214  Applicant to Surgical Technology Program

0718  Applicant to Truck Driver Training Program

0972  Applicant to Stage Technology (MSTAP)

0965 Applicant to Histologic Technician

B.  List high school, colleges and other training in chronological order.  Official transcripts (mailed from school directly to LCC) must be provided by applicant as required by program.

Schools Dates Major Areas of Study Degree

C.  List observation or job experiences specifically related to your career choice.  Please document with reference from supervisor.

Employer Type of Work Location Supervisor Dates

D.  Briefly outline your career goals and alternate plans.  Also describe why you have chosen this profession.

E.   (Note:  This question does not apply to Music Programs)
Do you have any physical, medical, emotional, or personal conditions/problems that would:

  1. Prevent you from completing ANY or ALL course requirements?    
  2. Jeopardize other's health or safety?   
  3. Jeopardize your own health or safety?   

4 - If yes to any of the above, please explain.

F.  Have you ever been convicted of a criminal offense? Yes   No
If yes, please explain.

Note:  Failure to provide this information may result in termination from the application process/program.

I understand that I must meet basic program admission requirements before I am eligible to receive admission ranking under Phase II for the Selective Admissions Program that I want to enter.  I further realize that I will be eligible to be considered for admittance to the program and that consideration will be given to candidates based on residency and additional criteria developed specifically by the Selective Admissions Program that I want to enter.

I also understand that I must take full responsibility for the following:

  1. Having official transcripts for high school and all college or professional school work sent as required to the Enrollment Services.
  2. Notifying the Enrollment Services of any changes in health since my original application that may affect my ability to complete the program.
  3. Updating information on the Selective Admissions Application (including current address and telephone number) if any changes occur prior to my starting the program.
  4. Meeting all application deadlines established for my program of choice.

I understand that if I am not admitted to my program of choice during an admission cycle, I will be required to reapply for admission during a subsequent admission cycle.

I give Lansing Community College my permission to contact the employer references that I have provided in this application.

The information that I have provided in this application is true and accurate to the best of my knowledge.

Full name

If you have questions, please contact the Enrollment Services Office at (517) 483-1254 or (517) 483-1256, or you can e-mail us at:  selective_admissions@lcc.edu

Note:  Lansing Community College reserves the right to establish or modify program admission requirements for any programs offered through the college.



Admissions - Phone: 517-483-1200 - Contact Us