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Arkansas State University

 

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Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information Your social security number is not required. However, it will help us match your information to any documents you may send in the future; such as: an application, transcripts, test scores, or financial aid/scholarship information.

Social Security Number
U.S. Social Security Number: (999999999 or 999-99-9999)

Birthdate
Date of Birth:Required Month Day Year (YYYY)

Gender
Gender: Male Female Not Specified

Information Ethnicity/race is not required. However, responses can be used to match your name to targeted academic, financial aid, and/or scholarship programs designed for specific ethnic groups.

Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian/Alaskan Native Asian Black/African American Native Hawaiian or Pacific Islander White Two or More Races Not Disclosed
American Indian/Alaskan Native
Asian
Black/African American
Native Hawaiian/Pacific Islander
White
Two or More Races
Not Disclosed

Information Please choose the academic term you are considering entering Arkansas State University. If you are graduating high school in May of 2012, you would begin classes at Arkansas State University in fall 2012.

Prospect Entry Term
Term of Entry:Required

Information Please click on the ‘Look Up High School Code’ button to select a high school.

High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:Required
Address Line 1:
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Colleges Attended
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

E-Mail Address
E-mail Address:
Verify E-mail Address:

Information Please choose up to 5 interests for which you would like to receive information. You may choose up to 5 by using Ctrl+Click on a PC and Command+Click for Mac.

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