Graduate Program Intention Form

Valparaiso University
The Graduate School
Graduate Intention to Enroll Form

Date:
Name:
Address:
City:
State:
Zip Code:
Country:
Email:
Daytime Phone:
Evening Phone:

Yes, I intend to participate in the program beginning
If you are an international student attending Valparaiso University, have you received your visa for entry into the United States? (Please type in "yes" or "no")
No, I cannot participate beginning in the semester I was admitted, but I am requesting a deferral of my admission to .
No, I will not enroll and am no longer interested in the program.

If not attending VU, please provide the following information:
Will you be attending another university? Yes No
If yes, which university:
Is there a specific reason that you did not choose Valparaiso University to continue your education?