UAHT Concurrent Application for Admission
Email address *
Name *
Maiden Name (if different)
Social Security or Government ID Number *
Street Address *
Street Address Line 2
City *
County *
State *
Zip Code *
Phone Number
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth (City, State) *
Email Address (NOT your high school email address) *
Enrolling for: *
Required
Enrollment Year *
Which UAHT campus do you plan to attend? *
Have you resided in the state of Arkansas for the last six months? *
Have you resided in Hempstead County for the last 90 days? *
Are you a United States citizen? *
Are you a permanent United States resident? *
Are you a current or former member of the US Armed Forces? *
Are you a current or former member of the National Guard? *
Are you a current or former member of the Reserves? *
What is your ethnic origin? *
Required
Gender *
Admission Status *
Required
High School Graduate Year *
High School Attended *
Did either of your parents complete a four-year college degree? *
Are you a convicted sex offender? *
Mark all classes that you plan to take in Fall 2020 on the UA-Hope campus. NOTE: Pay attention to the day and time. You can only take up to one MWF 8 class and one TR 8 class.
If you are taking a course on the UA-Hope campus other than the ones listed above, type the NAME of the course and the TIME it meets here. You can find the course schedule at https://www.uaht.edu/academics/class-schedules/academic-class-schedule/
Mark all classes that you plan to take in Fall 2020 ONLINE.
Mark the class that you plan to take in Fall 2020 on the Spring Hill High School campus
Clear selection
By checking this box, you (the student) are acknowledging that you have read and understood this form and give the University of Arkansas at Hope-Texarkana permission to release your academic record to the high school. *
Required
By checking this box, you (the student) are acknowledging that you are aware that you are enrolling in a college level course and therefore will adhere to all policies of the college as stated in the College Catalog. *
Required
By checking this box, you (the student) are confirming that you have discussed your enrollment and class choices with your parent/guardian and your high school counselor. *
Required
A copy of your responses will be emailed to the address you provided.
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