National Park Community College On-Line Admission Application

National Park Community College
www.npcc.edu
Application for Admission

It is recommended that you print this form in order to keep a copy for your files. If you do not want this information sent over the Internet you may print the form and mail it to:

National Park Community College Office of Admissions 101 College Drive Hot Springs, AR 71913	This application is for
	Full or Part-time?

Online Application for Admission
Fill out all fields below. Use the Tab key on your keyboard to move between fields. If some of the fields do not apply to you, do not enter any data.

This is required information.

I. Identification Information

NOTE: In order to apply electronically, the applicant's Social Security number must be provided.

Social Security Number	(Example: 123456789)

How did you learn about NPCC?		Reason for enrollment?

II. Personal Demographic Information


Title

Name	First Name	Middle Initial	Last Name	Suffix

	Preferred Name

Address	Current Address		# of years (0-99) # of months (1-12) How long have you lived at this address?

	City	State	If less than 6 months, State or Arkansas County

	County	Country	Zipcode

	Permanent Address

	City	State	Zip

Telephone Number	Home Phone (Example: 5015551234)	Work Phone (Example: 5015551234)

E-mail Address

Emergency contact information: Please list name(s) and telephone number(s):
Name	Number	Relationship


Date of Birth	(MMDDYYYY)
State of Birth
Gender
Are you a US Citizen?*
Are you a Veteran?


Do you plan to apply for financial aid?

*Due to additional paperwork required, International Students are not able to apply online at this time. Please contact the Registrar's office at (501) 760-4213 or (501) 760-4210 for application instructions. We look forward to assisting you with your educational goals.

III. Request for Confidential Information

The information requested below will be used for summary reports required by federal and state laws and regulations and to support institutional affirmative action efforts. It will not be used as a basis for admission or in a discriminatory manner. You will not be subjected to adverse treatment if you do not provide any of the requested information. National Park Community College provides academic accommodations as mandated by ADA and 504. Please contact the Student Support Services program at 760-4227 for disability assistance information.


I am interested in more information about accommodations

Ethnic Background

IV. Educational Information

Seeking admission as:

What is your intended Degree Plan?
(Students who are not seeking a degree from National Park Community College need to contact the office of Financial Aid to determine eligibility for Federal/State Financial Aid.)

V. Educational Background

High School Name

Are you presently enrolled in High School?
HS Grad Year	(Example: 2007)

List other colleges and dates of attendance below:
Institution	State/Country	Dates Attended	Degree Earned
	Arkansas
	Arkansas

You will need the documents below for full admission to NPCC:

Complete high school transript/GED (with date of graduation)	Test Scores (ACT, SAT, ASSET OR COMPASS)
Official transcripts from all previous colleges	Immunization records*
*Proof of immunization against measles and rubella is required by Arkansas state law of all applicants born after January 1, 1957 who are full-time students. Vaccines must have been received after the first birthday and January 1, 1968. All incoming freshmen must show proof of two measles (rubeola) and one German measles (rubella).
Official copies of high school and/or college and university transcripts along with ACT, COMPASS, ASSET and or other placement scores need to be mailed to NPCC.

By submitting this application, I affirm that the information is complete and correct. I understand that submission of inaccurate information can be cause for terminating my enrollment at National Park Community College.

When you have completed the Online Application for Admission, click the "Submit" button ONE TIME ONLY.

[ Return to the National Park Community College Home Page ]

Please send comments to WebMaster@npcc.edu