** ALL REGISTRATION MUST BE DONE ONLINE**

College Bound Arkansas Student Registration
June 14-16, 2017
College Bound Arkansas registration is limited (30). Applicants will be accepted on a first come, first served basis. Priority registration will be given to first time attendees. The cost to attend is $95.00 per student. Registration deadline is May 12, 2017. For further information, contact Carrie Tuttle at (501) 505-8855 or email ctuttle@conwaycorp.net.

Student Name(*)
Invalid Input

Please enter your first and last name.

Gender(*)
Invalid Input

Street Address(*)

City(*)

State(*)

Zip Code(*)

District(*)
Invalid Input

Please select your district from the list.

Home Phone Number(*)
Invalid Input

Grade for Fall 2017(*)
Invalid Input

College Bound Attendance(*)
Invalid Input

Student Email Address(*)
Invalid Email Address.

Parent Email Address(*)
Invalid Email Address.

Tshirt Size(*)
Invalid Input

Ethnic Group(*)
Invalid Input

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

Invalid Input

Other Disabilities
Invalid Input

Special Dietary Needs(*)
Invalid Input

Requested Accommodations Needed(*)
Invalid Input

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