Master of Business Administration Application

I. Enrollment Information

Planned Enrollment Date (Month & Year):
January
March
May
Late June/Early July
August
October

Year:

Enrollment Plan:
Full-time student
Part-time student

To which program are you applying?
MBA
MMA - Ministry Administration
JD/ MBA
MSN/ MBA
MBA - Engineering Degree
Engineering Management Certificate
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

II. Personal Information

Last Name

First Name

Middle Initial

Previous/ Maiden Name

Email Address

Street Address

City

State

Zip

Home Telephone

Work Telephone

Cell

Citizenship

Date of Birth

Gender

Ethnic Background

Religious Preference

III. Educational Background - All applicants are required to submit official transcripts.

Institution Name
Institution Location
Dates Attended
Degree Received

Institution Name
Institution Location
Dates Attended
Degree Received

Institution Name
Institution Location
Dates Attended
Degree Received

Institution Name
Institution Location
Dates Attended
Degree Received

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

IV. Employment Information - All applicants are required to submit a copy of their current resume.

Company Name
Company Location
Dates of Employment
Title

Company Name
Company Location
Dates of Employment
Title


 
Company Name
Company Location
Dates of Employment
Title

Company Name
Company Location
Dates of Employment
Title

V. Letters of Recommendation = Two letters of recommendation are required of all applicants. Please list the name of each reference below.

Name
Business/Institution Name
Title
Phone Number


 
Name
Business/Institution Name
Title
Phone Number

VI. Optional Information

Please list names and relationships of your relatives who have attended, or are now attending Valparaiso University.

Name
Relationship
Years Attended
Program

 
Name
Relationship
Years Attended
Program

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):

Reputation
Accreditation
Program of Study
Cost/Value
Location
Other:

VII. Signature

I submit this application as a true and complete statement of facts for your consideration.