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Request Information

Request Information

If you have a specific question or want to join our mailing list, please take a minute to fill out our online inquiry. By completing this information, you will receive information about Wittenberg University. Only the fields that are marked with an asterisk are required.

Personal Information

Are you:*   a U.S Citizen/Permanent Resident         an International
First Name:*       M.I.:      Last Name:* 
Preferred Name:  
Birthdate:*   M/D/Y     High School Graduation Year:* 
Gender:   Male Female    Citizenship

Contact Information

Home Address
Line1*/Line2:
  
City/State/Zip:*          
Country:    (If Outside U.S.)
Home Phone:       Cell Phone:  
Your E-mail:       Parent's E-mail: 

Interests

Academic Co-Curricular Extra-curricular

Academic Information

High School City:       High School State: 
High School Code/Name:*     / 
If you do not find the High School Name in the above list, please enter it in the High School text box below:
 

Transfer Students:

This section should only be completed by students
wishing to transfer from another college.
College City/State:     / 
College Code/Name:  / 
If you do not find the College Name in the above list, please enter it in the College Name text box below:
                                       
Cumulative GPA Of:    ON   Scale