Clark State College Interest Form

Thank you for your interest in Clark State!

Please fill out the form below to join our mailing list and learn more about what Clark State can offer you. Fields with a red * are required.

First Name

Last Name

Birthdate

Email Address

Mailing Address

Country

Street

City

Region

Postal Code

Mobile Phone number

May we text you?

Yes

No

Please type the city and state where you attended or are attending high school, for example, Springfield, OH or Spr***, OH and then choose from the list. GED recipients should type GED instead of a city and state.

What year did you / will you graduate from high school or obtain your GED?

If you have attended any college, please type the city and state where you attended, and then choose from the list.

What field are you interested in?

Are there specific programs you are interested in? If you are using a keyboard, you can choose multiple by holding down your Ctrl key. On a mobile device, your can choose multiple by clicking on the buttons.

What semester do you hope to start?

I'm interested in attending classes in: