Premier Club Sports Interest Form

Student Information

First/Given Name

Preferred First Name Learn More

Last/Family Name

Birthdate

Primary Citizenship

Most Recent School Attended

CEEB Code

Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Mobile Phone Number

By checking this box, you agree to receive occasional text messages from Valpo about events, application deadlines and scholarship reminders.

Yes

Academic Interest

Primary Academic Interest

I want to enter Valpo as a:

I want to start in:

Other Academic Interests (You may select up to 5 areas of interest.)

Premier Club Options

Previous athletic involvement, years played, coaches, etc.

Athletic achievements and awards

Valparaiso University admits students of any race, color, national or ethnic origin, age, gender, disability, sexual orientation, or religion.