New and High School Honors Application

Students who are currently enrolled in high school or have never attended Clark State who wish to apply to the Clark State Honors Program should complete the application below.

Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

E-Mail

Cumulative GPA (must be 3.5 or higher)

List any college prep or advanced placement classes you have taken.

List all ACCUPLACER scores.

List all college placement scores from other colleges.

High School

Date of Graduation or GED

List the major(s) you are interested in at Clark State

I plan to take most of my course at the following location(s) *

Springfield

Beavercreek

Bellefontaine

Xenia

Online

List any academic achievements/awards you have received.

I have met the following criteria for Honors Program eligibility *

A Clark State GPA of 3.3 or higher

I plan to enroll for six (6) or more honors credit hours if accepted.

If I am accepted to the Honors Program, I would like to take the following course for honors credit:

Course Name and Title:
Example: HST 1210 American HST to 1865

Course Section:
Example: ST01C, EE01C

Course Instructor:

I certify that all of the information above is to the best of my knowledge and believe true, correct and complete.

Consent for storing submitted data * Yes, I give permission to store and process my data