RETAIL MANAGEMENT DEGREE ON-LINE APPLICATION

This application is ONLY for the Retail Management Degree. If you would like to apply for other courses or degrees, please go to our General Application for Admissions.

Instructions:  This form is best viewed with the Internet Explorer browser. For Mac OS X/Safari users, please download and install Internet Explorer for Mac here or here, as there have been reports that Safari doesn't work correctly with this form.

Complete this application in its entirety, then click "Submit" at the bottom of the page.  You may click here to see a list of steps to enroll at NWACC.  If you don't wish to apply on-line, click here to print a paper application.  All information is transferred over a secure connection.

* Denotes a required field

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* Last Name:  
* First Name:  
Middle Initial:  
Maiden Name:  
* Social Security Number:  

Click here if you have questions about SSN's.
* Which year do you plan to attend NWACC?:  
* Which semester do you plan to attend NWACC?:  
* Have you previously attended NWACC?  
No    Yes    Year 

The next two questions are for research purposes only. Answers to these questions either way will not affect your admission into NWACC.
* Are you currently an employee of Walmart?  
No    Yes 
* Are you currently an employee of Sam's Club?  
No    Yes 

CURRENT MAILING ADDRESS, PHONE NUMBER, AND E-MAIL
* Street:  
* City:  
* State:  
* ZIP:  
Contact Telephone (including area code):  
Alternate Telephone (including area code):  
Email Address:  

RESIDENCY INFORMATION  (This section must be completed in its entirety).  A legal residence is one used for all purposes, including, but not limited to voting, vehicle registration, tax assessment, and driver licensing.

Legal Residence:

* Street (no PO Boxes):  
* City:  
* State:  
* ZIP:  
When did you move to this address?  
 
* Month:  
* Year:  
If you moved to this address less than six months ago, what was your previous address?  
 
Street (no PO Boxes):  
City:  
State:  
ZIP:  
* The above address is in the school district of:   
Bentonville
Rogers
Other  

EMERGENCY CONTACT In case of emergency, please contact:
Last Name:  
First Name:  
Middle Initial:  
Relationship to you :  
Phone (including area code):  
Street:  
City:  
State:  
ZIP:  
If you are under 18, who are your  
parents or legal guardians?  

ADDITIONAL INFORMATION:  (used for research purposes and federal and state reporting requirements, not for admissions consideration.)
* Birthdate:  
 
* Gender:  
Male   Female
* Ethnicity :  
*Required to choose 'Race' if you indicated
Non-Hispanic for 'Ethnicity'
* Race :  

OPTIONAL INFORMATION:  (used for research purposes and federal and state reporting requirements, not for admissions consideration.)
Marital Status:  
Annual household income:  
Highest level of education completed by your mother: :  
Highest level of education completed by your father:  
Do you have dependent children living at home?  
No    Yes 
Is English your first language?  
No    Yes 
What extra-curricular activities are you interested in?  
 Art  Drama/Theater
 Intramural Sports  Music
 Service-Learning  Honors Program
 Student Ambassadors/Leadership
How did you primarily hear about NorthWest Arkansas Community College?  
What other ways have you heard about NorthWest Arkansas Community College?  
 Family Member  Friend
 College Fair/Recruiter  Employer
 Public School  Live in Area
 NWACC Website  Mail
 Newspaper Ad  Radio Ad
 Movie Theater  NWA Mall
 NWACC Brochure
 Another College or University

SELECTIVE SERVICE REQUIREMENT
* I have registered with the selective service system.  
No*    Yes 
* I did not register for one of the following reasons:  

ARMED FORCES INFORMATION
* Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training?  
No    Yes 
* Are you a veteran of the U.S. Armed forces?  
No    Yes 
* Please select your military branch:  

US CITIZENSHIP
* Are you a US Citizen?  
Yes    No * 
If NOT a US citizen, what is your country of birth?  
* If you answered "No", do you have permanent residency status?  
Yes - You must provide a copy of your resident alien card before you will be able to register for classes
No - Your application will be forwarded to the Director of International Admissions before processing

* ENROLLMENT STATUS
New Freshmen – I have never attended college (not counting college courses taken while in high school)
Transfer student – I attended another college prior to NWACC
Readmitted NWACC student – I attended NWACC previously (not counting college courses taken while in high school)
High School student – I will be taking college courses on the NWACC campus while I am still in high school

* EDUCATIONAL INFORMATION
I graduated from high school or am currently attending high school:
           High School Name:     City:
                      State:
           Year of Graduation:   Month of Graduation:
                      Final GPA
           If you graduated from high school May 1, 2002, or later, you must submit a complete high school
           transcript.
I earned my GED.  Year:    State:   You must submit a copy of your score report or diploma
I did not graduate from high school and have not earned a GED

PREVIOUS COLLEGE INFORMATION

Check below each College or University you have attended, regardless of length of attendance or work completed. If you plan to earn a degree or certificate from NWACC, or apply for financial aid, you must request each college you've attended to send an official transcript to NWACC.
COLLEGE 1
COLLEGE   CITY   STATE
   
Dates of Attendance   Hours Earned   Degree Earned
   

 

COLLEGE 2
COLLEGE   CITY   STATE
   
Dates of Attendance   Hours Earned   Degree Earned
   

 

COLLEGE 3
COLLEGE   CITY   STATE
   
Dates of Attendance   Hours Earned   Degree Earned
   

 

COLLEGE 4
COLLEGE   CITY   STATE
   
Dates of Attendance   Hours Earned   Degree Earned
   
If you have previously attended more than four colleges, check this box:  

SUBMISSION OF APPLICATION

The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act requires that institutions of higher education distribute to all prospective students a summary of all criminal acts that occur on campus. The Clery Act Annual Security Report in its entirety is available here.

By submitting this application, I certify that I am the person for whom the application is entered. I certify that the information given is true and complete to the best of my knowledge. I understand that submission of false information is grounds for denial of admission or immediate suspension if enrolled. I give permission for the college to track my information through educational institutions that I attend. I also give permission for the college to retrieve my immunization records from the ADH Immunization Network for Children, if they are available. If accepted as a student at NorthWest Arkansas Community College, I agree to abide by the rules and regulations of the College regarding conduct and other obligations. In addition by submitting this application, I am certifying that I have read and understand the information my rights to view the information in the Cleary Act Annual Security Report.

By submitting this application, I also certify that I have read and concur with the information printed on page 2 of a paper application (available here.)

If under 18 at time of application, parent or legal guardian must read and concur with all information above.

   

 

For questions/comments on this form, please contact Enrollment Services.

This page was last updated on:  October 17, 2013 @ 11:46 am