If you would like to receive occasional text messages about important announcements and dates, please provide a valid cell phone
number below, and your cell phone carrier.
Carrier: _____________________________________________ Cell Phone: _________________________________________
Check box if you agree to the following terms: By participating, you consent to receive SMS/MMS marketing msgs.
No purchase required. Msg & data rates may apply from your cell carrier.
Do you wish the college to release Directory Information on you? YES ______ NO ______
Directory information includes name, address, phone number, place of birth, academic major, high school attended, non-academic honors,
dates of attendance, class schedule and classification. This information is released to third parties for the purposes of scholarship recruitment,
armed services recruitment and other reasons.
FINANCIAL AID/SCHOLARSHIPS (check what, if any, applies to you)
Self Pay
Payments are made in the Bookstore or payment plans are set up in MyCampus. Please contact the
SouthArk Business Office for Payment Deadlines
Pell Grant
Must submit signed award letter to receive Financial Aid
Student Loan
Must be enrolled in at least 6 hours
El Dorado Promise
Must successfully complete at least 12 hours each semester, 24 credit hours per Academic Year
Academic Challenge (Lottery Scholarship)
Must successfully complete 12 hours first semester, 15 hrs. each following sem. (27 hrs. first academic
year, 30 each following year)
Veteran/Veteran dependent (VA benefits)
After registering, submit a copy of bill to VA Rep. in Financial Aid Office (can be printed in Business
Office, 2
floor Administration building)
Institutional/Community Scholarships
Must adhere to all scholarship guidelines, see website for details
______________________________________ ____________ Schedule Approved by: _______________________________
Student’s Signature Date Advisor’s Signature
Spring 2021 Registration Form
Student Services Fax Number 870-864-7137
Student I.D. # _777-0Name: ___________________________________________________________ ____________________
Last First Middle Maiden
Street or Box City State Zip
Current Address: __________________________________________________________________________________________
Phone #: _________________________ Email: ___________________________ Major: ____________________________
Contact Person In Case of Emergency:
Name: _________________________________ Phone #: ________________________ Relationship: ____________________
Course Number
Course Title
End Time
SASC 0103
SouthArk Success
SASC 1101
Campus Technology
Total credit hours for semester:
click to sign
click to edit
click to sign
click to edit