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Information Request Form

Personal Information

*First Name:

*Last Name:

*Gender:

*Ethnicity:

*Date of Birth (mm/dd/yy):

Contact Information

*Address:

*City:

*State:

*Postal/Zip Code:

*Contact Phone:

*Country:

*E-Mail Address:

Degree Program

*Program of Interest:

*Degree Sought:

*What semester do you wish to attend the University of Arkansas?

Previous Education

Most Recent High School or Institution of Higher Learning:

Previous Undergraduate or Graduate Degree (if previously acquired):

Previous Undergraduate or Graduate Institution:

*Cumulative GPA:

*ACT/SAT Score:

Additional Information

Have you applied for admission to the University or Arkansas?

Are you an International Student?

Country of Origin:

Please enter any questions or comments below:

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University of Arkansas - College of Engineering - 4183 Bell Engineering Center - Fayetteville, AR 72701 - (479) 575-7455
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