High School Programs Request for Information

We welcome your inquiries to Valparaiso University. Please complete the form below and we will send you information about the program(s) that you are interested in, viewbook with information about Continuing Education at VU, admission guidlines, and much more.

Instructions
When entering your information please do not press the Return key until all information has been entered. Using the Return key while entering your data will submit your request with incomplete information. You may press the Tab key to move from one question box to another. All questions marked with a red asterisk (*) are required. When you have completed the form, make sure to click "Submit Request."

Basic Information
*Last Name
*First Name
Former Name
NOTE: Required for those who have inquired, applied, attended, or graduated from a program at VU under a different name. This is done so that duplicate files are not created for one person in our computer system.
*Gender
*Date of Birth
 
Address
*Address
*City
State
Country
NOTE: Required for those who live outside of the United States.
*Postal Code
 
Contact Information
*Home Phone
Cell Phone
*Email
If you do not have an email address, please type None.
 
Citizenship
*To ensure that we provide you with the correct forms and applications, please indicate your citizenship:
 
*How did you learn about VU?
To help us in our continued effort to offer quality educational programs, please tell us how you heard about our programs at Valparaiso University.
If "Other", please specify:
Academic Information
*Start Term
 
Please indicate from the list of program(s) that follow what information you would like to receive.
Young Scholars Academy
  Specific class you are interested in:
 
College Experience High School Program
 
High School Special
 
Thank-you for filling out a request for information. Please check all information before submitting this form.
Valparaiso University does not unlawfully discriminate on the basis of gender, disability, race, color, age, national origin or ancestry in the admission of students nor in its hiring and employment practices.