UCA Academic Outreach

University of Central Arkansas

Phone: (501) 450-3118 Fax: (501) 450-5277 Aug. - Dec 2008

All of the colored fields are required before submitting this form.

Check here if you took the online survey for 10% off one class.

Discount does not apply for courses offered through the Community School of Music, Community Language School, FACS credit courses, Gatlin Education Services or Ed2Go.

Payment Options:

Pay credit card by phone
Mail-in Payment
Please bill me by email

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*Home Phone:

Work Phone:

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	*Start Date	*Course Title	*Course Fee
1			$
2			$
3			$
4			$
5			$

*Denotes required field
All material fees are to be paid directly to the instructor

Student-Initiated Refunds will be given if requested at least two working days before the day of the first class meeting. After that time, no refunds can be given. No refunds are issued if you fail to attend class. All class cancellations or changes initiated by the student are subject to a processing fee of $5 per course.

University of Central Arkansas 201 Donaghey Ave Conway, AR 72035-5003
For general inquiries or comments, call 501-450-3118, fax 501-450-5277, or email Academic Outreach & Extended Programs.