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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

Educational Goals

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.

* Will you be seeking Financial Aid?

High School/GED

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

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

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:

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, 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 AVP 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:

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Ozarka College Aviation
ATTN: John Catlett
524A Airport Road
Melbourne, AR 72556


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