A G S 2 0 1 9 |Resident Assistant Application - Page 1
Arkansas Governor’s School Resident Assistant Application
Full Legal Name: ______________________________________________________________________
Permanent Address: _____________
Email address: ______ Cell Phone: ( __) _____________ Date of Birth:
Current College/University Name: ____________________
Address of College: _____________________________________________________________________
(Street) (City) (Zip)
Major: Minor: GPA: _______________
Previous Arkansas Governor’s School Experience (dates and roles):
Please provide an official copy of your current college transcript, including your grades for the Fall 2018 semester. You
may either include your official transcript in its own sealed envelope along with the rest of your application OR contact
your college or university and request that an official copy of your transcript be sent to:
Department of Residence Life
Arkansas Tech University
Doc Bryan Suite 211
1605 Coliseum Dr.
Russellville, AR 72801
If you have any questions please contact us at:
Arkansas Governor’s School
Phone: (479) 968-0391
Email: ags@atu.edu