Application for the Bachelor of Applied Science Degree

Student Identification Number *

Year of intended enrollment: *

Semester of intended enrollment *

Fall (late August)
Spring (mid-January)
Summer (late May)

Full Legal Name (The full legal name you give on this application will be used for all of your college records.) *

First Middle Last

Former Name: (If applicable - used for identification of credentials).

If you were a previously enrolled student whose name has changed since your last registration, send an email to the Records office at records@lorainccc.edu with a copy of your driver's license to have your name updated in the system.

First Middle Last

Mailing Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone

Home Phone

Work Phone

Can we send you text messages? *

Yes
No

Emergency Contact Name *

First Last

Relationship *

Emergency Contact Phone *

Email Address *

List a valid and active email address where you can be reached for the next six months. Keep your email address updated by notifying the Records office with any changes at records@lorainccc.edu.

Have you received an associate degree? *

Yes
No

Have you completed at least 60 semester credits of college courses? *

Yes
No

I understand that I need to send my official transcripts to LCCC before I can register for upper division Microelectronic Manufacturing (MEMS) courses. *

I understand

Have you attended a BAS information session or an interview with the Microelectronic Manufacturing BAS coordinator? *

Yes
No

If yes, when?

I hereby certify that, to the best of my knowledge, the information provided on this application is true and complete and that I have read the instructions contained in this application. I understand that if found otherwise, it is sufficient cause for delay of admission, loss of credit, rejection or dismissal. I understand that I am responsible for any charges that I may incur as a student at LCCC including, but not limited to, tuition and fees. I will notify the Records office of any demographic or academic changes before my first enrollment and prior to any subsequent enrollment if changes occur. *

Yes

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Engineering Programs

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Application for the Bachelor of Applied Science Degree