Fillable Military To It Program Application (Lansing Community College)

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Military To It Program Application (Lansing Community College)

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The Military To It Program Application (Lansing Community College) form is 3 pages long and contains:

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  • 11 check-boxes
  • 73 other fields

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File type: PDF

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MILITARY IT TO IT
PROGRAM APPLICATION
Complete this form and return along with the required documentation to: 4100W-
Technical Careers Division, Lansing Community College, 5708 Cornerstone Drive,
Lansing, Michigan 48917, or fax to 517.483.1320, or email mitch24@lcc.edu
Name
______________________________________________________
Last Middle First
Date of Birth
___/___/_____
LCC Banner Student #: __________________
Address
______________________________________________________
City
_________________
State
Zip Code __________
Preferred Telephone
O Home
O Cellular
Home
(_____) ______- __________
Cellular
(_____) ______- __________
Email
________________________
Military Service
1) What is your currently military status?
If discharged, did you receive
an honorable discharge?
2) In which branch/branches of the Armed
Services are/were you a member?
ACTIVE DUTY
NATIONAL GUARD
RES ERVE
DISCHARGED
YES
NO
ARMY
NAVY
AIR FORCE
MARINES
COAS T GUARD
List dates of military service and military occupation area. Official military transcripts
must be provided by applicant as a requirement of the program.
Armed Service
Dates
Military Occupation
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
06160071
List of al
l military or civilian IT experience
Service
Armed Service & Civilian Dates Duties Performed
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
_______________________ _____________________ _______________________
Do you retain a current IT or higher certification/license?
Certification
Dates
_______________________ _____________________
_______________________ _____________________
_______________________ _____________________
_______________________ _____________________
Who Issued the Certification
_______________________
_______________________
_______________________
_______________________
Colleges
School Dates Major Areas of Study Degree/Certificate
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
Career Goals
Briefly outline your career goals. Also describe why you have chosen this profession.
ACKNOWLEGEMENT
I understand that I must meet the basic requirements for admission to my program.
I also understand that I must take full responsibility for the following:
1.
Having official transcripts for all college or professional school work sent as required to
the Enrollment S
ervices Office
2. Notifying the Military Medic Program of any changes in health since my original application
that may affect my ability to complete the program
3.
Updating information on the Military IT to IT Program Applic
ation (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
I under
stand 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.
The i
nformation that I have provided in this application is true and accurate to the best of my knowledge.
Applicant Signature: ________________________________________ Date: ____________________
If you have questions, please contact the Military to IT Program at 517.483.1553
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Military To It Program Application (Lansing Community College)

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Completed 21 July 2020

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