Cooperative Agreement Request

Cooperative Agreement Request

KCC's Cooperative Agreement request allows KCC District residents the opportunity to attend partnering Illinois community colleges without paying out-of-district tuition rates for occupational programs not offered by KCC. The benefits apply only to occupational degree and certificate programs and the specific required courses therein.
Cooperative Agreement Guidelines
- Applicants do not need to be current KCC students, have a KCC email, or a KCC application on file.
- Applicants must reside within the boundaries of KCC’s District #520.
- The requested degree or certificate program criteria can NOT already be offered at KCC.
- Only Occupational degree/certificate programs qualify for cooperative agreement.
- Transfer programs, individual courses and/or courses needed in persuant of a transfer degree program do not qualify for cooperative agreement.
- Approvals are only valid for the current academic year.
- Request may be denied if classes have already begun upon submission.
Please allow 7-10 business days for processing and approval.

Cooperative Agreement approval is not guaranteed.
Upload a copy of your driver's license, state ID or voter's registration card to verify residency.*

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Full Name*

First NameMiddle NameLast Name
Student ID
Enter your seven-digit KCC student ID
Birthdate*

MonthDayYear
Phone*
Please provide a valid phone number
Email*
example@example.com

Residency
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Have you lived at the residence listed above less than one year?*

YesNo
Please give previous address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Are you a registered voter?*

NoYes
County where you are registered to vote*

I certify:*

I understand that this program is not being offered at Kankakee Community College. Should I fail to enroll in the above mentioned program, I shall assume all responsibility for tuition and fee expense incurred in my enrollment at the approved institution. I hereby understand that the approved school will permit me to study in the program that I have requested at their in-district tuition rate provided that I stay within the guidelines of the program. Deviation from the program will result in my paying out-of-district tuition rates. Marking "I Agree" indicates that I understand this agreement is for the program specified above.I Also Understand that distance is not considered a basis for approving Cooperative/Chargeback Agreements. If a program is offered anywhere within the cooperative network, it is judged to be available. The time of day, day of the week, the particular semester or term of offering, or the program or its component parts are not considered as factors affecting approval. Cooperative/Chargeback Agreements are not available for transfer programs.I further certify that the information contained in the notification is true and correct.
Signature

Clear
Signature Field: Signature*
To print your form, choose Print BEFORE submitting.
FOR OFFICE USE ONLY

 Residency verified  Program verified

 Approved for cooperative agreement  Disapproved for cooperative agreement

Date: __________________ Authorized signature: __________________
Should be Empty:

Cooperative Agreement Request

Residency

Cooperative Agreement Program