Adult Admissions Information Request Form

E-mail Adult Admissions

*International students inquiring about a student visa should e-mail the International Student Office.

*Your Information ( denotes REQUIRED)**
*Birthdate (mm/dd/yy):
Have you ever applied or taken classes at COD?:	Yes No
Beginning Term (enter the term you plan to begin attending COD. Please refer to the Class Schedule calendar above):
*Name:	First Middle Last
*Address:
*City:		*State:	*Zip:
Gender:	Female Male
*Phone number:
*E-mail address:

Ethnicity (optional):
	Native American/ Alaskan Native	Asian or Pacific Islander	Hispanic	Black/ non-Hispanic	Caucasian/ non-Hispanic
Other

What is your career goal? (select one)

Accounting/Auditing
Art
Biological,Life and Pre-Med
Computer and Technology
Design
Early Childhood Edu and Care
Earth,Space and Atmo Sciences
Engineering/Engineer Tech
English/Journalism and Comm
Fire Science/EMT/Paramedic
Graphic Design/Graphic Arts
Health Sciences
HT
Human Services
Humanities
Industrial and Service Tech
Languages
Legal Studies
Management/Marketing/Sales
Mathematics
Motion Picture/Television
Office Support and Management
Performing Arts
Photography
Physical Education/Health/Wellness
Physical Sciences
Psychology
Social Sciences
Speech Communications
Teacher Preparation
Undeclared

What is your highest level of education completed at the START of classes at College of DuPage?

Where did you first hear of College of DuPage? (select one)

Alumni
Business visit
Community Event
C.O.D. faculty/staff
Employer
Family/friend
High school counselor
High school visit
Movie ad
Newspaper ad
Radio/TV ad
Web
Other

My Question is: