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Application To Attend A Recognized
Illinois Public Community College

TO: Rend Lake College
District #521
Ina, IL 62846

Please fill out this application if you reside in Rend Lake College’s district.

EXAMPLE:
I live in Rend Lake College’s district, but I would like to attend John A. Logan for a program that
Rend Lake College does not offer.

For more information, please view this Document

First Name

Last Name

Phone Number

Email Address

Address

City

State

Zip Code

Date of Birth (mm/dd/yyyy)

I hereby certify that I reside within Rend Lake College District No. 521 and make application to attend a recognized Illinois public community college.

I certify that I intend to enroll as a student in the curriculum and college during the semester/year periods specified below:

Title of Program

College

Program Type

Beginning
Semester / Year

Ending
Semester / Year

Notes
/Comments

Application To Attend A Recognized Illinois Public Community College

TO: Rend Lake College​District #521Ina, IL 62846

Please fill out this application if you reside in Rend Lake College’s district.

Application To Attend A Recognized
Illinois Public Community College

TO: Rend Lake College
District #521
Ina, IL 62846