Please Submit Form To:
Jeremy L. Youmans
Director, International Programs
jyoumans@nwacc.edu
479-619-2224
Reduced/Concurrent Enrollment Application
Name: _____________________________________ NWACC ID# _______________________
Semester Requested: _________________________ Preferred Hours of Enrollment: _______
Student Signature: _________________________________________ Date: _____________________
Please choose one of the following:
Student has difficultly with the English Language or reading requirements (FIRST TERM ONLY)
Unfamiliarity with American teaching methods (FIRST TERM ONLY)
Has been placed in an improper course level due to an Advising or Counseling
Student has an illness or medical condition which prevents him or her from carrying a full course of
study. Must be certified by a medical doctor (M.D.), doctor of osteopathy (D.O.), or licensed clinical
psychologist/psychiatrist (include license number below)
Student has verified through an official degree check that he/she needs _____ hours (FILL IN NUMBER)
to complete the degree program. Student will complete the degree program no later than the end of
this semester.
Concurrently enrolled at ____________________________________ for ______ credit hours.
(MUST TAKE 6 HOURS LIVE WITH NWACC AND ATTACH ENROLLMENT TO THIS FORM)
Comments: (Please attach additional sheet if needed)
_________________________________________________ _____________________
Academic Advisor/Medical Doctor Signature Date
_________________________________________________ _____________________
PDSO Signature Date
