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Request for Information About Lane Community College


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Information We would be pleased to send you information about any area of the college. Please enter your information in the following fill-in form and click "Submit". Thank you for your interest in Lane Community College!

Required - indicates a required field.
Your Name
First Name: Required
Middle Name:
Last Name: Required

Your Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
State or Province:
ZIP or Postal Code:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
Phone Country Code:
International Access Code:

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Term you Plan to Start at Lane
Term of Entry:

Information The following information about your high school is not required, but is very helpful.

High School Information
Home Schooled (check for yes):
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
State or Province:
ZIP or Postal Code:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Information What are you thinking about studying? Want to find out more about athletics, clubs, or campus life? You can select up to 5 interests from the list below. To select more than one, use Ctrl+Click for PC and Command+Click for Mac.

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