Program Admission Form

This admissions form is applicable to the following degrees offered by The Northwest Water and Energy Education Institute (NWEEI) through Lane Community College's Science Division.

Energy Management with Building Controls Technology

Instructions

NWEEI logo

This form should only take about 10 minutes to complete. You must have a student "L" number before you begin.

The information requested in this application is needed to assure all applications for any of the above programs will receive full and impartial consideration. Please be as complete and accurate as possible in your responses. It is the responsibility of the applicant to inform the office manager of any incorrect/incomplete submissions, missing documents, name or address changes.

NOTE: If the program enrollment exceeds capacity and a selection process is required, preference will be given to those who have submitted complete application forms prior to July 1 for Fall enrollment.

Student "L" Number *

Otherwise known as your Student Identification Number, your "L" number is provided to you after Applying for Admissions to Lane Community College. If you've forgotten your number, use the self help to have it emailed to you.

Program Selection

Anticipate starting classes (term/year): *

Indicate the term/year you anticipate to begin taking classes. The program follows a logical series of classes starting Fall Term. Most program specific classes are offered once a year. Mid-Year enrollment (Winter/Spring) is possible for eligible students.

Do you anticipate being a full time or part time student?

Your answer assists our ability to assist students with workload and internships. It has NO impact on your official student status with the college.

Online Readiness

Three things you should know...

Online classes are held almost entirely online utilizing a learning management system we call Moodle.

Not all of the actual work is done at a desk in front of a computer. Some lab type activities may be left up to you to complete on your own while other fieldwork will require assistance from an assigned Fieldwork Mentor.

Fieldwork is not part of every class but for classes that require it, you will be expected to communicate, schedule and complete it in a timely mannor.

Additionally, a few classes may require you to use an online proctor (fees not included in tuition) while taking tests or final exams.

VIDEO CORRECTION: We use Moodle not Canvas but the same principal applies!

Online classes are not easier than their face-to-face equivalents. In addition to learning your course material, you must be able to: Login, Cut, copy, paste, Upload, download, Email, attach, Post, comment, communicate, navigate, participate, Save, search, review, critique and edit content.
Online classes require a lot of self disipline, ability to manage schedules and time effectively, ability to communicate in writing, and that you are able to troubleshoot and work with technology.

Are you ready? *

By checking the box below, you are acknowledging you have read and understand the information presented above. If you signup for classes and begin feeling frustrated or 'over your head', we have resources to assist you. Please ask! Don't know if your ready or not? There are several resources on the internet that can assist you in determining your current strengths and weaknesses. Contact the program for additional information.

I'm Ready to go!

Name & Contact

First Name *

Middle Initial

Last Name *

Previous Name(s)

If you've recently changed your last name or usually go by a nickname please put previous names here so we can cross reference your information.

Date of Birth *

Month

Day

Year

Preferred Email Address(s) *

You can enter multiple email addresses separated by commas. Example: firstemailaddress@asdf.com, secondemailaddress@bogasco.com. You must at least include your Lane Gmail email address.

Preferred Phone *

This number will only be used if we have questions about your application and or if an emergency arises while enrolled in the program.

Are you a U.S. citizen? *

Yes

Physical Address

Street *

City *

State *

Zipcode *

Is your Physical Address the same as your Mailing Address? *

Mailing Address

Street

City

State

Zipcode

Highschool

Have you Completed Highschool? *

Yes

Did you graduate with a degree or GED?

Degree

GED

High School Attendance *

Please list the name of the High School attended and include the City, State and Zip where it is located. If you are currently attending high school, please send your transcript through the next to last grading period.

College (if applicable)

List each college that you attended (including LCC), the last year attended, and any degrees received.

College Attendance:

List each college that you attended, including LCC, the last year attended and any degrees you received.

Upload Supporting Documents

Upload any UNOFFICIAL transcripts and/or GED scores from high school or other post-high school institutions. If you want to transfer classes from another College, OFFICIAL transcripts must be sent directly to College Admissions. It is your responsibility to include an LCC transcript. If you don't have this information available in a digital format and or have difficulty uploading documents, you can provide this information either in person or in a follow up email when requested.

Note: Multiple file uploads are not currently supported. Either combine all your supporting documents into a single document (single PDF with multiple pages) or upload up to 3 documents using this webform.

Upload Count

How many individual documents would you like to upload?

Upload#1

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx xls xlsx.

Upload#2

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx xls xlsx.

Upload#3

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx xls xlsx.

Work Experience

Current Employment:

List your current employment include how long you have been in that position.

Any work in the Energy, Building Controls, or Water Conservation field?

Please list here any work you have done in the Energy, Building Controls, or Water Conservation field and describe the work.

Tell us why you want to enroll in this program:

Referred Via *

How did you find your way here?

Sign Your Application

I , have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I give permission for a program representative to contact me using the information provided in order to obtain suplimental documenaton or supply additional information about the program I'm applying to. Additionally, I agree to comply with the requirements and directions of the training program and, to supply any information relevant to safety and/or related medical issues.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Check the box below to sign

Electronic Signature *

I am electronically signing my application as

* By checking this box, I am electronically signing my application as .

Leave this field blank