Course Approval Form for Non-degree Seeking Students

Completing this form does not guarantee approval for course enrollment. Students who are approved will receive notification by email and will be required to submit/complete the following: registration form, student data form, tuition and fees, complete all UAMS compliance requirements including verification of student health insurance, medical exam, flu vaccine, HIPAA online training, and TB skin test. The email notification will include information regarding the above requirements.

Name
First Last
Name of course: * Required
Reason for taking the course: * Required
In which state do you currently reside? * Required
Are you a UAMS employee? * Required
If you are a UAMS employee, how will tuition and fees be paid (self pay, department, etc.)? If by department, please list department contact.
Email * Required
* Required
- I understand that as a non-degree seeking student I will be required to pay tuition and fees and will be responsible for completing all compliance requirements.