Class Enrollment Request

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This form allows students to request enrollment into ECE Practicum education course(s) within the Arkansas Tech University College of Education.

*ECE students will only submit their Practicum course(s) on this form. All other courses will be enrolled by Dr. Timothy Leggett.

Students who have questions about who their assigned education advisor is, please contact the Teacher Education Student Services Office by phone at (479) 968-0290 or by email at lgibson7@atu.edu or vscott@atu.edu.

First Name *

Middle Initial *

Last Name *

Maiden Name, if applicable

T Number *

Please include the "T" before the number.

Last Four Digits of Social Security Number (For AELS Verification) *

ATU E-mail Address *

Contact Number - Cell *

What is your major field in education? *

ECE (Early Childhood Education-Associates Degree ONLY)

Elementary Education (ATU)

What is your current GPA? *

For ECE Practicum coursework students must meet GPA program requirements.

Have you met with your advisor to determine your course enrollment? *

Yes

Please list the course enrollment code given to you by your advisor. *

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