EOC Online Application Form

  • Section 1 - STUDENT INFORMATION

  • XXX-XXX-XXXX
  • MMDDYYYY

  • Section 2 - DEMOGRAPHIC STATUS

  • XXX-XXX-XXX

  • Section 3 - FINANCIAL INFORMATION

  • Section 4 - EDUCATIONAL INFORMATION

  • Section 5 - AUTHORIZATION

    I declare that the information on this form is true to the best of my knowledge. The UALR Educational Opportunity Center Program is authorized to access information deemed necessary to assist me in achieving my educational goals or in meeting the reporting requirements of the U.S. Department of Education, to record pertinent facts regarding my eligibility in the Program, services rendered, and placement. A copy of this statement shall serve as such authorization.

  • Section 6 - ACTIVITIES AND WORKSHOPS (please check all that apply to you)

  • Section 7 - EDUCATIONAL GOALS AND CAREER PLANS

    Please complete the following survey. Your answers will aid in planning workshops at your school. Thank you.