Thursday, April 17th, 2014

Application for Admission


  1. (required)
  2. (required)
  3. (required)
  4. (required)
  5. (required)
  6. (valid email required)
  7. Enrolling for
  8. Resident Status
  9. Have You resided in Arkansas for the last 6 months?
  10. Have You resided in Hempstead County for the last 90 days?
  11. Are you a United States Citizen?
  12. Are you a permanent U.S. Resident?
  13. Ethnic Origin
  14. Sex
  15. Admission Status
  16. Are you a current high school student?
  17. List all colleges and universities previously attended in order of attendance
  18. Have you attended UACCH before?
  19. Student Level
  20. To select multiple hold down Ctrl key and select with mouse
  21. When you complete your degree at UACCH, do you plan to transfer to another institution?
  22. Did either of your parents complete a four-year college degree?
  23. (required)
  24. Indicate by submitting this form that you have read and understood all of the information on this application and the information you have provided is factually correct and honestly prepared. Full-time students are required to submit proof of measles and rubella immunization prior to admission. Failure to provide this proof of immunization will result in your being withdrawn from the courses in which you are enrolled. The UACCH College Catalog provides all of the policies and procedures students are required to follow. Please obtain a copy of the Catalog and be familiar with its contents.