Registration - Southern Arkansas University


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* required field

Last Name*	First Name*	Middle Initial
Address*
City	State	Zip Code
Daytime Phone Number*	Email Address*
Name of course*		If registrant is a child, please provide age
check credit card Payment method (please check)

If payment is made by check, please send your name, address, and check to: Southern Arkansas University P.O. Box 9240 Magnolia, AR 71754-9240 If payment is made by credit card, please telephone our office at 870-235-4005 with your card number and expiration date.

Southern Arkansas University, 100 E. University, Magnolia, Arkansas 71753-5000

(870) 235-4000