Request Information
Welcome to Lincoln Land Community College
About you
We need this information so we can make sure to connect you with the correct resource at LLCC.
First Name
Last Name
Date of Birth
What is your preferred method of contacting you?
Email
Text
Phone Call
Email
Mobile Number
Street Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
Additional Information
This information is optional, but will help us serve you best if you provide it.
What would you like to study at LLCC?
If you want specific program information, please complete this.
When do you anticipate starting?
High School
Other High School (If high school not shown)
Graduation Year
Ex: 2024
Have you already applied to LLCC?
Yes
No
Family or Friend Information
This section is optional. If you'd like for your parent(s), other family members, or just a friend to receive more information about college and LLCC, please include their information below.
Family Member Name
Family Member Email
Family Member Phone
Family Member Mobile
Thank you for providing information a
bout yourself.
What information would you like from us?
Which bests describes you?
Please select...
Adult Student
Current High School Student
Recently High school Student
Comments
Today Date
Agreement
By pressing submit,
I consent to receive communications via phone, text, and email from LLCC. Msg & Data rates may apply. Opt out anytime.