LLCC Open Door - Workforce Equity Initiative 20/21 Application
This form asks basic information about the prospective student, including education, employment, household and program interest. It will also ask for 3-5 sentence statements on the following:

1. Explain why you are applying for this program and how you will benefit from participation.
2. What is your motivation for pursuing participation in this program?
3. What barriers/obstacles do you anticipate impacting your success in this program?
4. Explain your career goals as they relate to this program?
5. What inspired you to choose this field of study/career?

Questions about how to complete this form? Call 217-786-2413.
For more information, visit www.llcc.edu/open-door-wei.
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Peterson, Sierra *
Date of Birth *
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Address *
City *
State *
Zip Code *
Home Phone Number (include area code) *
Cell Phone Number (include area code) *
County *
Email *
Gender *
What is your marital status? *
Are you in the United States on a visa or as a non-resident alien? *
If yes, your country:
Ethnic background: *
Do you require any special accommodations?   *
If yes, please describe:
Have you ever been convicted of a felony or misdemeanor? *
If yes, what was the conviction/charge?
Do you have a valid Drivers License? *
If no, please explain:
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