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IECC Admissions Form
Contact Information
First Name
Last Name
Middle Name
Alternate Last Name
Email Address
Confirm Email Address
Home Address Line 1
Home Address Line 2
City
State
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
FOREIGN
GED
Georgia
Guam
Hawaii
HS
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Military Americas
Military Europe
Military Pacific
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Mariana Islands
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Republic of Palau
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
ZIP Code
Birth Date
Cell Phone
Social Security Number
Please submit your social security number. If it is unavailable please type 999999999. This will delay the processing of your registration, and you will be contacted for this missing information by our staff.
Citizenship Status
US Citizen
Permanent Resident Alien
Non Citizen with Visa
Non-Citizen
Unknown
Sex at birth
Male
Female
Gender Identity
Man
Woman
Trans Man
Trans Woman
Non binary
Unknown or Not Listed
Ethnicity
Hispanic/Latino
Non-Hispanic/Latino
American Indian/Alaskan Native
Yes
No
Asian
Yes
No
Black or African American
Yes
No
White
Yes
No
Native Hawaiian or Other Pacific Islander
Yes
No
Middle Eastern or North African
Yes
No
Non-Resident
Yes
No
Military Status
None
Veteran
Active Duty
Reason for Enrollment
Personal Interest
Highest Degree Earned by Student
None
High School
Certificate
Associates
Bachelors
Masters
PhD
Professional
Highest Degree Earned by Either Parent
Parent did not attend college
Some college no credential
Certificate
Associates Degree 2 yr
Bachelors Degree 4 yr or higher
Emergency Contact First Name
Emergency Contact Last Name
Emergency Phone Number
Emergency Contact Relationship
Aunt
Brother
Child
Daughter
Emergency Contact
Father
Fiancé (Male)
Fiancée (Female)
Friend
Grandfather
Grandmother
Guardian
Husband
Mother
Other Adult
Other Relative
Self
Significant Other
Sister
Son
Spouse
Step Brother
Step Daughter
Step Son
Stepfather
Stepmother
Uncle
Widower
Wife
Entry Term
Fall 2025
Spring 2026
Summer 2026
Fall 2026
IECC Drivers Ed Schedule Options
Please choose one session of the class.
Behind the Wheel ONLY Individually Scheduled
Behind the Wheel ONLY Individually Scheduled
Behind the Wheel ONLY Individually Scheduled
Jan 13-March 3, 2026 Tues&Thurs 1-3pm
June 9-July 16, 2026 Tues/Wed/Thurs 9:30-11:30am
March 17-May 5, 2026 Tues&Thurs 1-3pm
Please type your name after reading the following information.
Watch for your confirmation email with more instructions and a second email with your login and password from accounts@iecc.edu. The disclosure of a social security number is voluntary and not required for enrollment in an Illinois Eastern Community College but will delay processing of your information. contact 618-546-2357 to discuss your options. A student requesting financial aid/scholarships or expecting to receive tax information will be required to provide a social security number. •I certify that all information is accurate and complete and that I am responsible for keeping IECC up to date with my current name, physical address and phone number by submitting a Student Information Update Form to the Registration and Records Office at my college. •I acknowledge that by completing registration for classes I am entering into a legal binding contract with Illinois Eastern Community Colleges #529 to pay fees by the payment due date. I understand that if I do not drop my class within the allowable cancellation period (Refer to Refund Policy in IECC catalog), then I am financially obligated to pay for the course even if I never attend any class sessions. I understand that any remaining unpaid balance at the applicable midterm will be assessed a one-time 5% fee. Should I default on payment, I understand that I shall be responsible for all collection costs and legal fees that IECC may incur to collect any unpaid balance. Collection costs range between 25% and 33% of amount owed. I further acknowledge that any money owed to IECC under a payment plan constitutes an education loan that cannot be discharged in federal bankruptcy. •I authorize IECC and its agents and contractors to use text messages, personal calls and emails, in their efforts to contact me regarding my student account and general information about IECC. Furthermore, I understand that I may withdraw my consent to call or text my cellular telephone using automated telephone dialing and/or texting equipment by submitting my request in writing (email, text, or letter) to IECC or the applicable contractor or agent contacting me on behalf of IECC. I understand and agree that IECC uses email as an official method of communication and that I am responsible for reading the emails received from iecc.edu on a timely basis. •I understand and agree that IECC is NOT RESPONSIBLE for providing accident, health, or medical insurance for medical services and that I am solely responsible for any and all medical bills incurred as a result of injury or loss during my participation in IECC classes. I certify the above statements are correct and complete. If student is under the age of 18, a parent/guardian signature is required and will be requested at a later date. Please type the student name below.
Illinois Eastern Community College District No. 529 does not discriminate on the basis of race, color, sex, pregnancy, gender identity, sexual orientation, age, marital status, parental status, religious affiliation, veteran status, national origin, ancestry, order of protection status, conviction record, physical or mental disability, genetic information, or any other protected category.
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