Viterbo University

Viterbo University Request Information

First Name

Last Name

Home Phone:

Cell Phone

International Student?

Can we text you important updates about your application, events, or deadlines?Do Not AllowAllow

Birth Date (mm/dd/yyyy)

Address

Email

City

Confirm Email Address

State

Legal Sex

ZIP/Postal Code

Gender Identity

Extracurricular Interest

Personal Pronoun and Chosen First Name may be used for mailings, academic communications, class rosters, etc.
If Chosen First Name is the same as Legal Name, please leave blank.

Personal Pronoun

Chosen First Name

Are you a U.S. Military Veteran?YesNo

Are you currently U.S. armed forces active duty personnel or U.S. armed forces reservist?YesNo

Are you a dependent of a U.S. Military Veteran?YesNo

Academic Area

Undergraduate – high schools students, transfer students, and traditional-aged prospective college students
Bachelor Completion – adult students interested in online/evening courses, including RN to BSN completion
Graduate – prospective students with undergraduate degrees interested in a master’s degree, doctoral degree, or a graduate certificate/license

Academic Program

Entry Term

Admit Type

Comments:

Prospect Inquiry

Viterbo University Request Information