It is recommended that you print this form in order to keep a copy for your files.
You can also download the Printable Version and send it in via fax or regular mail.
Southern Arkansas University Tech
Office of Admissions
P.O. Box 3499
Camden, AR 71711
Voice: (870) 574-4558
Fax: (870) 574-4478
Instructions - Complete 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.
State of Arkansas - Statement of Selective Service Status in Compliance
with ACT 228 of the 1997 Acts of the Arkansas General Assembly.
I understand that to be eligible for admission to Southern Arkansas University Tech,
I must register, or be 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 exempted from such registration because of the following
provision(s) of the Military Selective Service Act or Act 228 of the 1997 Acts of the
Arkansas General Assembly.
*** If the answer to either question is 'Yes', send details in an email
to email@example.com; include date, name of court, nature of
offense, status of charge, penalty imposed, if any, or other disposition.
By submitting this application, you affirm that you have read and understood all the information
on this application and the information you have provided is factually correct and honestly prepared. Any
misrepresentation of facts could be cause for refusal of admission or suspension from the college.
When you have completed the Online Application for Admission, click the "Submit" button ONE TIME ONLY.
Please send questions or comments to Admissions