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Inquiry Record Form

* Student's Name:

* Address:

* City:

* State:

* Zip:

Home Phone:

 Cell Phone:

* Email:

Currently enrolled at      High School

Dropped out of      High School

Please select the appropriate date and time from the list below and type it in the Informational Meeting Date box.  NOTE: all information meetings are held on Wednesdays. If Wednesdays will NOT work for you, please contact our office at 517-483-9707 to schedule an alternate time.

  •  November 5, 2014 3-5pm

  • November 12, 2014 3-5pm

Informational Meeting Date:

* You are eligible for the program if you:

are between 16 and 19 years old

reside in Ingham County or Eaton County

have finished at least 1/2 of your high school credits

* Referred by:

High School Personnel

LCC Personnel

TV Public Service Announcement

TV Interview

Radio Interview

Radio Commercial

Friend/Word of Mouth

Special Event


NCG or Celebration Cinema

LCC Website

Community Partner Meeting

Community Partner Mail

Juvenile Justice System



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High School Diploma Completion Initiative at Lansing Community College

High School Diploma Completion Initiative
Mackinaw Building, Room 214
Phone: (517) 483-9707
Additional contact information »

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