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After completing this form, print a copy for your records then click on submit.


Biographic

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Social Security Number: we respect your right for privacy. State/Federal reports and Federal Financial Aid require the use of your SSN. Ozarka College will issue you a student ID number that will be used to reference your account.

Contact Information - Addresses













If any of your records are under a different name, please provide complete name used:




Optional Information



This information is requested for the completion of various federal and state reporting purposes. Ozarka College does not discriminate in admission of students on the basis on gender, disability, age, race, national origin, or religion as specified by TITLE IX of the Educational Ammendment of 1973.

Emergency Contact












Military Service
Are you a veteran or presently in military service, or a dependent of a military service member?



If any of your military records are under a different name, please provide complete name used:




Educational Goals
* Will you be seeking Financial Aid?











Criminal Justice, Culinary Arts/Hospitality, Licensed Practical Nursing, Registered Nursing
all have additional admission requirements and instructions. Please contact the admission office to request Details.

High School/GED










For GED, only enter the Year of completion and the state the GED was awarded in.

Educational Background
Example: your mother has a 4 year degree and your father does not, please enter 4 year degree.

Are you currently enrolled in a college or university?







List in chronological order all colleges and universities you have attended. Each applicant for admission to the Ozarka College must have each college or university attended send an official transcript of his/her work to the Office of Admissions,Ozarka College, 218 College Drive, Melbourne, Arkansas 72556

Name of Institution City State Entered Departed
mm/dd/yy
Degree Date
mm/dd/yy


Have you ever been suspended from another college or university?










I certify that the information contained in this application for admission is true and correct. I understand that misrepresentation or omission of information will be cause for dismissal and loss of credit. Should any of the information on this form change prior to my entry to the Ozarka College, I will immediately notify the Office of Admissions.


The following is needed before a student can be enrolled in the College:
Entering freshmen: a six- or seven- semester high school transcript upon application, a final transcript upon graduation, and the American College Test (ACT) scores, ASSET, or COMPASS scores.

Selective Service Statement
I understand that to be eligible for admission to the Ozarka College in Melbourne, I must register, or exempt from registration, with the Selective Service System in accordance with the Military Selective Service Act, 50 U.S.C. Appx 451 et seq, as specified in Act 228 of the 1997 Acts of the Arkansas General Assembly.

I therefore swear or affirm under penalty of perjury that I have registered with the Selective Service System, or I am exempt from such registration because of the following provision(s) of the Military Selective Service Act or Act 228 of the Acts of the Arkansas General Assembly:










Notes
To apply for admission to Ozarka College, the following credentials must be submitted:
  • This electronic application or a formal application for admission.
  • An official copy of a high school or GED (General Education Development) transcript indicating date of graduation and official transcripts of all colleges or universities attended.
  • Proof of immunization against measles, mumps, and rubella.
  • An official copy of the ACT, SAT, ASSET, Compass or AccuPlacer results.
    (These are student assessments that are used for placement in Math and English. Ozarka College is an open enrollment institution, however; certain programs may consider these scores as criteria for selection.)
I certify that the information contained in this application for admission is true and correct. I understand that misrepresentation or omission of information will be cause for dismissal and loss of credit. Should any of the information on this form change prior to my entry to Ozarka College, I will immediately notify the Admissions Office.

I hereby give permission to Ozarka College to use, in booklets, press releases and other promotions, the applicant's name and any school photograph or video or footage in which this applicant may appear. These images may appear in any of the wide variety of formats and media now available to the college and that may be available in the future, including but not limited to print, broadcast, videotape, CD-ROM and electronic/online media.

I authorize Ozarka College to access my immunization record through the Arkansas Department of Health and Human Services Immunization Register.

"Be it resolved: Ozarka College is an affirmative action/equal opportunity institution. In keeping with its non-discrimination policy in employment, admissions and other functions and programs, the College considers employees and students on the basis of individual merit without regard to sex, race or color, religion, national origin, age, condition of handicap, or other factors irrelevant to participation in its programs."

Information concerning completion or graduation rates of degree-seeking, full-time students entering Ozarka College, and Campus Security information is available on request from the VP of Students Services, (870) 368-2027.

Please mail supporting application documents to: Office of Admissions Ozarka College P.O. BOX 10 Melbourne, Arkansas 72556.

By submitting this application, I agree to abide by the policies and procedures found in the current Ozarka College catalog available at: http://www.ozarka.edu/catalog



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Ozarka College Aviation ATTN: Nick Lenczycki
524A Airport Road
Melbourne, AR 72556

870.368.7926

nick.lenczycki@ozarka.edu

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