Planned Enrollment Date (Month & Year): January March May June August October
Year:
Enrollment Plan: Full-time student Part-time student
To which program are you applying? MBA MBA Plus Sustainability Certificate (Fall I Only) JD/ MBA MSN/ MBA MEM Business Management Certificate
Have you previously applied for admission to Valparaiso University? No Yes If yes, when
If yes, to what College? Arts and Sciences Nursing Engineering Business Law Graduate
Have you previously enrolled at Valparaiso University? No Yes If yes, when
Last Name
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Date of Birth Month January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Gender Choose one Male Female
Ethnic Background Choose one Asian American Indian/Alaskan Black/African American Hawaiian/Pacific Islander Hispanic/Latino Mexican American Puerto Rican White/Caucasian Multracial Other
Religious Preference
Have you ever been placed on probation or dismissed by any college, university, or professional school for any reason? No Yes If yes, please attach explanation
Please list names and relationships of your relatives who have attended, or are now attending Valparaiso University.
How did you learn of the Valparaiso University Graduate Programs in Management? (Check all that apply) College Adviser Valpo Alum Professor Recruiter Relative or Friend Religious Organization Printed Material Website Billboard Graduate Fair Mailer Internet
Please list other programs to which you are applying:
Please order the factor(s) that will affect your choice for graduate school (1 being most important):
I submit this application as a true and complete statement of facts for your consideration.
