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Admissions

Special Admissions - Nonpublic Home School/ Approval Form

  1. PRINT OUT a blank form (below)

  2. FILL IT OUT

  3. 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

Social Security Number:

 

______________________________
Last Name

_______________________________
First Name


Note to Parents and Students: 

Is the responsibility of the student and/or parent (s) or guardian (s) to provide the Lansing Community College Admissions Office with required approvals and documents at least two weeks prior to registration. LCC requires basic skills assessment for all new students. This application must be completed for each semester of enrollment. A student may audit or take the course for credit.


PARENT / LEGAL GUARDIAN APPROVAL

I, the undersigned, approve the above-named student to enroll at Lansing Community College for:

Course Number:_______________    Course Title:___________________________

I am applying for the Nonpublic Home School Program

 I am applying for the Special Admission Program

I waive any claim against Lansing Community College for injury, loss or damage whatsoever, caused by any person rendering any services of the program caused by outsiders. I understand that my son or daughter is participating in an adult educational environment and I hereby assume responsibility and hold Lansing Community College harmless for any adverse consequences of that participation. I understand that enrollment is contingent upon an available open seat in the course selection selected and approval from the department / division. If my son or daughter is a home school student, I confirm that he/she at least 14 years of age.
 

___________________________
Signature of Parent / Legal Guardian

_________________________
Area Code/ Telephone Number

_____________
Date




HIGH SCHOOL APPROVAL

I approve the enrollment of the above named student:

Course Number:__________  Title:________________________________ at Lansing Community College. I have conferred with the student and family and believe this enrollment for (Semester/ Year) _______________ is the best interest of the student. This recommendations being made for reasons of educational enrichment, not to promote social or athletic goals.

___________________________________
Signature of School Official

_______________________
Title

_____________
Date


_________________________________________
School of Jurisdiction


_____________
Area Code/Telephone



LCC OFFICE USE

INSTRUCTIONAL DEPARTMENT APPROVAL

Approved

I, approve enrollment of the above named student.

Course Number__________________ Title _______________________________ at Lansing Community

College for (Semester/ Year) ___________.

It is my opinion that the student is capable of handling the course requirements.

___________________________________
Signature of Department Head or Designee

______________________
Department

_____________
Date

Not Approved
I deny enrollment of the above named student.

Course Number__________________ Title _______________________________ at Lansing Community

College for (Semester/ Year) ___________.

because ___________________________________________________________________

___________________________________________________________________________
 

___________________________________
Signature of Department Head or Designee

_______________________
Department

_____________
Date

ENROLLMENT SERVICES APPROVAL

LCC Office Use Only                             Department Approved  Not Approved
 

___________________________________
Director of Admissions

____________
Date

_____________
Semester

___________
Year

After completed the Approval form above, please go to the
Special Admission Application Form



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