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CDL Training Inquiry Form

Community / Workforce Solutions / CDL Training

Please fill out the form below to receive additional information about our truck driver training at Clark State.

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Parking Citation Appeal Form

College Life / Parking

Clark State appeals are processed by completing an online Citation Appeal form. This form and your citation must be received by the Office of the Vice President for Business Affairs within ten days of the date the citation was issued. The Appeal Form must be filled out completely. The payment of the…

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VA Benefits Enrollment Reporting Request Form

Financial Aid

This form must be completed in its entirety each semester/term you register for classes before the School Certifying Official can report your enrollment in order for you to receive your GI Bill® benefits from the Veterans Administration (VA). If you have any questions, please contact the Veterans Se…

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Basic Police Officer Inquiry form

Academics

Completion of this form does not automatically enroll you in the Clark State Basic Peace Officer Training Academy or Clark State College. It is for informational purposes only. Upon submittal of this form, you will be contacted by the Academy Commander. To complete enrollment, call 937.328.7960.

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Clark State Wellness Center Informed Consent, Voluntary Waiver, Release of Liability and Assumption of Risk Form

College Life / Health and Wellness / Wellness Center

PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT. THIS FULLY SIGNED FORM MUST BE SUBMITTED BY PARTICIPANT BEFORE PARTICIPANT IS ALLOWED TO USE THE CLARK STATE COLLEGE WELLNESS CENTER’S EQUIPMENT AND FACILITIES.

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Bellefontaine First Year Placement Evaluation Form

Admissions / Placement Assessment / First Year Placement Evaluation - Bellefontaine

All fields with an asterisk (*) are required. If any of the below information is not correct delays can occur in processing and notification.

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Xenia First Year Placement Evaluation Form

Admissions / Placement Assessment / First Year Placement Evaluation - Xenia

All fields with an asterisk (*) are required. If any of the below information is not correct delays can occur in processing and notification.

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Clark State Springfield Visit Form

Admissions

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Clark State Now Accepting Applications for Fall Entry Into Registered Nursing Programs

Community / News

Applications for the fall 2015 Registered Nursing programs are now being accepted. Information about the application and acceptance process and the application form are available online.

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Clark State Associate Professor Honored for Poetry

Community / News

Clark State Community College Associate Professor Chris Bays has been honored for his poem “Despite Rising Seas” which took 1st place in a national poetry contest. Haiku Society of America sponsored the contest for Best Unpublished Haibun of 2017. The haibun, a hybrid form, combines prose poetry wit…