I verify that I have read this application and that it is accurate and complete to the best of my knowledge. I agree to provide documentation necessary to verify information reported on this form. I understand that the Talent Search Transition Program will use the data provided on this form to assist in assessing any academic and/or career planning needs and that all of the information will be used in the strictest of confidence. I certify that all the information provided is correct to the best of my knowledge.

You will need to provide each of the following documents by uploading them below in this online version, faxing a copy to 847-608-5493, or sending a copy through email to talentsearchtransition@elgin.edu

If the required documents are not uploaded, the application will be incomplete. You must contact us, as noted above, to get the documents to us in another manner to complete and fully submit the application.

Medical History

Does your child have any of the following?

Emergency Contacts for Student

I hereby give permission to the appropriate office of SCHOOL NAME BELOW to issue a transcript for STUDENT INFORMATION BELOW

Permission is hereby authorized to ECC Talent Search Transition Program to release or request information from authorized officials to maintain my educational records.

To meet the guidelines set by FERPA for the sharing of student information, the Talent Search Transition Program at Elgin Community College requires a signed document with the signatures of both the student and the parents/guardians agreeing to the following:

{schoolName97} and Elgin Community College will share all information necessary for the admission, enrollment, and progress of students that are enrolled in the Talent Search Transition Program at Elgin Community College.

Communications are “limited” to the sharing of information between the Talent Search Transition Program administration, faculty, and staff at Elgin Community College and the counseling, administration, faculty, and staff at the school.

As per Elgin Community College Policy, instructors and/or other ECC staff are permitted to share information with the student only and not with parents/guardians or other individuals.

Both the student's and parent/guardian's signatures are required.

I do hereby irrevocably authorize, the Board of Trustees for Community College District No. 509, commonly known as Elgin Community College, its officers, employees, agents, successors, assigns and those acting under its permission and with its authority, to copyright, publish, duplicate, or otherwise use, disseminate, and/or dispose of, for art, advertising, information, educational purposes, trade, or any other lawful purpose whatsoever, any medium, including but not limited to, photographic pictures, digital images or recordings, DVD’s, videotapes, software, website entries, sound recording of me or in which I may be included in whole or in part, or composite or distorted in character or form, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium and taken at any location of Elgin Community College or any production location determined by Elgin Community College.

I do hereby waive any right to inspect or approve the finished product or adverting or other copy that may be used in conjunction therewith or the use to which it may be applied now or in the future. I also hereby waive any right to royalties or other compensation from the Board of Trustees for Community college District No. 509, commonly known as Elgin Community College, its officers, employees, agents, successors and assigns.

I hereby agree to hold harmless, release and discharge the Board of Trustees for Community College District No. 509, its officers, employees, agents, successors, assigns and all persons acting under its permission or authority, including and firm publishing and/or distributing the finished product in whole or in part, whether on paper, via electronic media, on web sites, or some other format from and against any and all claims, demands, damages or liability, including reasonable attorneys’ fees and court costs which I may have, arising from or relate to the use of any photographic pictures, digital images, or recordings, DVD’s, videotapes, software, website entries, sound recordings of me or any other medium, including but not limited to any misuse, by virtue of blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking, processing, reduction or production and completion of the pictures or in any processing tending toward the completion of the finished product, its publication or distribution. I understand that this release binds my heirs, executors, administrators, and assigns, as well as myself.

I do hereby certify that I am of legal age (18 years or older) and I am competent to contract in my own name in the above regard I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that if for any extraordinary reason my privacy must be protected after the submission of this document, I must notify Elgin Community College in writing. I further understand that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

If the person signing is under age 18, consent must be given by a parent or legal guardian as follows:

I, the undersigned, hereby certify that I am the parent or legal guardian of {printedMinors}

I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I do hereby agree to the terms in this release and give my consent without reservation to the foregoing on behalf of the above named minor. I understand that if for any extraordinary reason the privacy of said minor, must be protected after the submission of this document, I must notify Elgin Community College in writing. I further understand that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.