Social Security Number (no dashes)
(If you don't know your SSN, please leave field blank.)
Dependent children/child under the age of 18 must reside with you, or you have full or joint custody.
Single parent: unmarried or legally separated with a dependent minor children/child.
Married parent: married with a dependent minor children/child.
Women who are now pregnant should answer "yes" and select single or married according to their relationship status.
Someone who is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment;
Someone who has never worked outside the home, depending on someone else for their income;
Someone who has worked without pay to care for a home and family and for that reason has diminished marketable skills.
By submitting this form 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. I further certify that the above statements are complete and correct. Illinois Valley Community College does not discriminate on the basis of age, religion, national origin, color, gender, mental or physical disability in admission to or its employment policies.
Your application will be verified and processed within 10 business days.
If you click submit and you are not re-directed to a confirmation page, please refresh your browser. If the problem persists, please give us a call at 815-224-0439