High School Group Information Group Name: Contact Person: Street Address: City: State: ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: Phone Number: Email: Note: We can accommodate 55 total persons in the group including students and chaperones; one chaperone per 10 students is required. Number of Student Visitors: Number of Chaperones: What grade(s) are your High School students in? (Check all that apply; we cannot accommodate elementary and middle school students.) 9th 10th 11th 12th Visit Information What date(s) would you like to visit campus? (Please include at least 3 options) Note: You are not guaranteed the date for this visit until you receive a confirmation. Date 1: Date 2: Date 3: Information Session In addition to your campus tour, are you interested in an Informational Session given by one of our Admission Staff members? Yes No Comments Please tell us briefly about your organization and why you chose to visit Valparaiso University. After submitting your request form, please scroll to the top of the page to view the message verifying successful submission.