Concurrent Credit

High School Application for Admission

You can also download the Printable Version and send it in via fax or regular mail to the address below.

Southern Arkansas University Tech
Secondary & Community Educational Services
P.O. Box 3499
Camden, AR 71711
Voice: (870) 574-4476
Fax: (870) 574-4538

Concurrent Enrollment Memorandum of Understanding

Have you ever received college credit through SAU Tech? *

Social Security Number: *

Example: 555-55-5555
Term: *

Last Name: *
First Name: *
Middle Name
Maiden Name:

Address: *

City: *
County: *
State: *
Zip: *

Home Phone: *
Other Phone:
Birth Date: *

Example: 12/12/1990

Ethnicity: *


Gender: *
Marital Status: *
Arkansas Resident: *
United States Citizen: *

Selective Service: *

Enrollment Location: *

High School: *
Current Grade Level: *
Graduation Date: *

E-mail: *

Courses:  **Students must meet all eligibility requirements before their registration is processed. Total hours cannot exceed eleven.
Course # Sec # SAU Tech Course Title Credit Hrs Days Time Location

All courses taken will be for college credit. SAU Tech does not award high school credit. The student must see the high school principal or counselor to discuss this option.

Have you taken the ASSET test at SAU Tech? *
Have you taken the COMPASS test at SAU Tech? *

Have you taken the ACT test at SAU Tech? *
Have you taken the SAT test at SAU Tech? *

By clicking the Submit button you indicate that you have read and understood all the information on this application and the information you have provided is factually correct and honestly prepared.