1. BIOGRAPHICAL DATA
First Middle Last
Telephone Number Email
Please check: Public School Private School Home School
Name of High School
Year of Graduation High School GPA Rank in Class
2. FORMAL TEST DATA. List your highest exam scores. Please do not superscore or mix
sub-set scores from separate exam dates.
3. ADVANCED COURSEWORK. Attach one copy of your current high school transcript. Your
transcript will be reviewed and kept within the University Honors program. A separate
transcript for admission purposes should be sent with your admission application to
the Office of Admissions, Arkansas Tech University, 141 Doc Bryan, Russellville AR
List any honors courses and the grades you received in the appropriate year.
List any concurrent courses, the institution, the appropriate year, and the grades
4. HONORS AND ACTIVITIES.List the academic honors and awards you have received, and indicate the year in which
you received them.
List the most important extracurricular projects or programs in which you have participated.
5. ESSAY. Provide a typed essay of 300-500 words attached to a separate email. Please
DO NOT submit writing that has been considered for essay and/or scholarship competitions.
Choose one of the following topics:
A. A current political or social issueB. An exceptional novel you have read and why you consider it noteworthyC. A travel experience that made a significant impact upon your life
Dr. Jan Jenkins, Professor of History and Dir University HonorsDepartment of History and Political Science407 West Q St, WPN 239BRussellville, AR 72801I hereby affirm that all information supplied in these blanks is complete and accurate.
It is my understanding that I shall not be considered for a University Honors interview
until I have submitted all credentials specified.