Arkansas Transition Services - Arkansas Transition Services

** ALL REGISTRATION MUST BE DONE ONLINE**
REGISTRATION IS LIMITED (30).

College Bound Arkansas Student Registration
June 3-5, 2024

Applicants will be accepted on a first come, first served basis. Priority registration will be given to first time attendees.
A teacher or parent may need to help complete this application.

Registration deadline is May 3, 2024.
For further information, contact Carrie Tuttle at (501) 505-8855 or email ctuttle@conwaycorp.net.

Student Name(*)

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Please enter your first and last name.

Gender at Birth(*)

MaleFemale

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*ATS will implement Act 317

Date of Birth

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Please be sure to include the month, day and year: mm/dd/yyyy

Street Address(*)

City(*)

State(*)

Zip Code(*)

District(*)

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Please select your district from the list.

What school do you attend?(*)

Home Phone Number(*)

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Student's Current Grade (2023-2024 School Year)(*)

10th Grade11th Grade12th Grade

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Have you attended College Bound Arkansas before?(*)

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Student NON-SCHOOL Email Address(*)

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(Please list an email that the student can access during summer hours)

Parent Email Address(*)

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Tshirt Size(*)

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Ethnic Group(*)

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Disability Category (Please select all that apply.)(*)

ADD
Autism
Cerebral Palsy
Deaf-Blindness
Emotional Disturbance
Hearing Impairment (Including Deafness)
Intellectual Disability
Mobility
Multiple Disabilities
Orthopedic Impairment
Traumatic Brain Injury
Other Health Impairment
Psychiatric
Specific Learning Disability
Speech or Language Impairment
Tourette's Syndrome
Visual Impairment (Including Blindness)
Other (Please list below)
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Other Disabilities

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Accommodations at College Bound Requested

InterpreterGluten-Free LunchVegetarian LunchWheelchair AccessOther (please list below) Invalid Input

Other Accommodations at College Bound

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Please list the name of the person who will transport the student to and from the UCA campus.(*)

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Please enter first and last name.

Transporter's Phone Number(*)

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We will be verifying your attendance one week prior to the camp. Please list a phone number we may reach you at IN THE SUMMER to confirm attendance if different than above.

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Do you currently use assistive technology?(*)

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If yes, what type?(*)

If yes, do you have a plan for maintenance for devices after high school?(*)

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Briefly describe your plan for maintenance for devices after high school.(*)

If no, would you be interested in learning about a specific type of assistive technology?(*)

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Which type of assistive technology would you be interested in learning more about?(*)

(e.g. note taking devices, medication reminders, etc.)

What concerns do you have or barriers do you anticipate in going to college?

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A teacher or parent may need to help complete this section.

Please list the student's post-secondary goals from their Transition Plan.(*)

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Has the student had any work experience in high school?(*)

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Has the student prepared for the ACT Compass or completed it?(*)

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Does their high school have a Career Coach?(*)

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Is there a Transition Class at the student's high school?(*)

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Does the applicant participate in the Transition Class?(*)

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Upon receipt of your registration form you will be sent a confirmation email letting you know that we have received it. The email will contain a Participation Agreement; Photo Release; and IEP/504 Verification form that will need to be signed and returned before your registration is complete.
If you do not receive the confirmation email within 4 hours of submitting registration, please check your spam folder.

You will also receive a questionnaire via email in May that must be completed to attend College Bound.

IF YOUR PLANS CHANGE AND CAN'T ATTEND, YOU MUST NOTIFY US.

Enter the letters you see in the field provided(*)

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If you are having issues submitting the form, please contact bonnie.boaz@ade.arkansas.gov.

Please only click the submit button once.