Are you employed as a law enforcement officer?
This program is restricted to members of law enforcement. Please complete our traditional application.
Legal First Name
Legal Middle Name
Legal Last Name
Birth Date (mm/dd/yyyy)
If you are applying for financial aid, foundation scholarships or intend to receive year-end tax reporting documents, your social security number is needed.
Are you Hispanic or Latino/Latina?
Race (Choose one or more)
Are you a veteran?
Branch of Military Service
Address, continued (as needed)
County of residence
Primary Phone Number
Confirm Email Address
As part of the ILEPP, you are required to send your transcripts to Richland Community College, One College Park, Decatur, IL, 62522 or to email@example.com. Please provide your name, date of birth, and that you are part of the ILEPP if submitting unofficial transcripts.
GED Completion Year
High School State
Select Institution from List
School Not in List
Select GED Institution from List
Name of School (not available in dropdown list above)
High School City/Town
Richland Community College does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs. The following person(s) has been designated to handle inquiries regarding the nondiscrimination policies:
Jody Burtnett, Title IX Coordinator at phone 217-875-7211 EX 6288Leanne Brooks, 504 Coordinator, at phone 217-875-7211 EX 6362
For further information on notice of nondiscrimination, visit http://wdcrobcolp01.ed.gov/CFAPPS/OCR/contactus.cfm for the address and phone number of the office that serves your area, or call 1-800-421-3481.
I certify that all of the information on my Registration Form is correct and complete.
Planned Starting Month
Planned year to start program