Acceptance & Deposit Form | University of Arkansas at Pine Bluff

Acceptance of Admission Form

We're excited to welcome you to The Pride! Please complete the form below to let us know you're coming!

First Name * (First Name is required)

Middle Initial * (Middle Initial is required)

Last Name * (Last Name is required)

Date of Birth * (Date of Birth is required)

Address * (Address is required)

Address 2 (Apt #)

City * (City is required)

State * (State is required)

Zip Code * (Zip Code is required)

Email Address * (Email Address is required) (Email Address must be a valid email address)

UAPB Student ID Number * (UAPB Student ID Number is required)

I will be enrolling for:*

Fall 2022

Spring 2023

(I will be enrolling for: is required)

I will be enrolling as a:*

Freshman/First-year Student

Transfer Student

(I will be enrolling as a: is required)

Do you accept UAPB's offer of admission?*

I accept UAPB's offer of admission.

I am declining UAPB’s offer of admission.

(Do you accept UAPB's offer of admission? is required)

If declining to attend another school, please tell us which one.

If declining, please take a moment to complete our survey. Your input will help us better serve other students. Take survey.

Certification of form responses:*

By clicking the check box, I hereby certify that the responses provided on this form are true, and agree to fulfill all financial obligations as outlined in the form.

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