Prospective Student Information Request

Complete the following information.  Fields that are marked with an * are required.  The information submitted is secure and confidential.  Thanks for your interest in MVNU.

*First Name:
Middle Initial:
*Last Name:
*Address:
 
*City:
*State:
*Zip code:
*Country:
*Gender: F M
*Birthdate: (01/01/2001)
Church Attending:
Email:
*Home Phone:
Cell Phone:
*High School:
*School Type: Public
Private
Home School
*Graduation Date: (06/01/2001)
*Estimated GPA (3.456):
Ethnicity (Optional): American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Hispanic or Latino (Optional): Y N
*Did parent(s) attend MVNU: Y N
*Is parent(s) a pastor: Y N
*Is parent(s) a missionary: Y N
*First Major Preference:
Second Major Preference:
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Select Extracurricular Interest(s):
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*Interest Level in MVNU:
*How did you hear about MVNU:

Through this submission, I allow MVNU Admissions to contact me via mail, email and telephone to provide me with additional information about the University and its programs.