Cooperative Agreements

OR

I understand that it is my responsibility to provide Illinois Central College with a current plan of study showing all courses to be taken from the college in which I plan to enroll. This program of study must also include the descriptions for the courses. The plan of study must be emailed (in pdf format) to cooperativeagreements@icc.edu or mailed to the address below within a week of this form submission AND at least 30 days prior to the beginning of the semester in which I plan to enroll. Enrollment Services — Cooperative Agreements Illinois Central College 1 College Drive East Peoria, IL 61635-0001

I, hereby, certify that to the best of my knowledge the foregoing information is true and complete without evasion or misrepresentation. I understand that if facts are found to be otherwise, such discovery shall be sufficient cause for rejection of my request or revocation of permission if previously granted. Checking the box and entering your full, legal name below will serve as your electronic signature and verification of your submission and agreement with the terms of the cooperative agreement. I understand that Illinois Central College may request additional information, including my Social Security Number, upon approval of the agreement for identification purposes.