UAHT Concurrent Application for Admission
Email address *
Name *
Maiden Name (if different)
Social Security or Government ID Number *
High School
Street Address *
Street Address Line 2
City *
County *
State *
Zip Code *
Phone Number
Date of Birth *
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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 Graduation Year *
High School Attended *
Did either of your parents complete a four-year college degree? *
Are you a convicted sex offender? *
List the classes you plan to take online in Fall 2020. *
List the classes you plan to take on the UA-Hope or UA-Texarkana campus in Fall 2020.
List the classes you plan to take at your high school in Fall 2020.
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 UAHT 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 high school counselor. *
Required
A copy of your responses will be emailed to the address you provided.
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