Prospect Inquiry

Viterbo University Request for Information

First Name

Last Name

Chosen First Name

If same as above, please leave blank

Pronouns

Email Address

Confirm Email Address

Cell Phone:

Home Phone

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

Birth Date (mm/dd/yyyy):

Extracurricular Interest

Have you, your spouse, or your parent(s) served in the U.S. Military?

Are you an International Student?

Check if address is outside of U.S. or Canada

Address

City

State

ZIP/Postal Code

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, including the post-baccalaureate teacher licensure

Academic Program

Entry Term

Admit Type

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