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UAHT Concurrent Application for Admission
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Maiden Name (if different)
Your answer
Social Security or Government ID Number
*
Your answer
Street Address
*
Your answer
Street Address Line 2
Your answer
City
*
Your answer
County
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone Number
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Place of Birth (City, State)
*
Your answer
Email Address (NOT your high school email address)
*
Your answer
Enrolling for:
*
Fall
Spring
Summer
Required
Enrollment Year
*
Your answer
Which UAHT campus do you plan to attend?
*
Hope
Texarkana
Both
Have you resided in the state of Arkansas for the last six months?
*
Yes
No
Have you resided in Hempstead County for the last 90 days?
*
Yes
No
Are you a United States citizen?
*
Yes
No
Are you a permanent United States resident?
*
Yes
No
Are you a current or former member of the US Armed Forces?
*
Yes
No
Are you a current or former member of the National Guard?
*
Yes
No
Are you a current or former member of the Reserves?
*
Yes
No
What is your ethnic origin?
*
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native
White
Two or more races, mark all races that apply
I choose not to answer
Required
Gender
*
Male
Female
I choose not to answer
Admission Status
*
First Time Freshman (First-time attending any college AFTER high school)
High School/Concurrent (High school student taking classes on a high school or UAHT campus)
Visiting Student (Degree seeking at another institution)
Transfer (Degree seeking at UAHT and attended another institution previously)
Non-Degree Seeking (Not seeking a degree at UAHT)
Re-Admittance (Have attended UAHT before, after high school graduation)
Required
High School Graduate Year
*
Your answer
High School Attended
*
Your answer
Did either of your parents complete a four-year college degree?
*
Mother
Father
Both
Neither
Are you a convicted sex offender?
*
Yes
No
Mark all classes that you plan to take in Fall 2020 ONLINE.
Art Appreciation
Music Appreciation
Sociology
Speech
Other--please list the course in the space below.
If you are taking a course online other than the ones listed above, type the name(s) of the course(s) below.
Your answer
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.
*
Yes
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.
*
Yes
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.
*
Yes
Required
A copy of your responses will be emailed to the address you provided.
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