Buena Vista University

Special Student Application

Required Fields (*)

Student Information

Male     Female

Contact Information

Admissions Information

High School     Non-Degree Seeking Student
Yes     No
Mother     Father     Guardian    

Please list both parents' address if divorced or separated:

List all high schools and colleges attended: (*)
SchoolDates attendedReason for leaving

Optional Fields

Single Married Divorced Separated Widowed Other
Baptist Catholic Disciples of Christ Jewish Lutheran Methodist
Presbyterian Episcopal      Other:
White Caucasian Hispanic Native American Asian Black/African American
Asian Hawaiian/Pacific Islander 2 or more races Non Resident Alien (not a citizen)

By clicking submit, you agree that the information furnished on this application is complete and correct, and that any deliberate omission or falsification of information may result in denial or dismissal.