Your Information

Your College Plans

Where do you plan to live?

At Home Residence Hall Off Campus

Academic Interest

Please select the area of study that you wish to pursue at Virginia Union University.

Enrolled Type

Full-Time (12 credit hours or more) Part-Time (less than 12 credit hours)

Enroll Term

First Name

Middle Name

Last Name

Suffix

Preferred First Name

E-mail Address

Home Phone Number

Cell Phone Number

Mailing Address

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Is your permanent address the same as above?

Yes No

Permanent Address

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Your Family

To whom should we send information?

One Parent Both Parents Legal Guardian

Parent

Relationship

Title

First Name

Last Name

E-mail Address

Phone Number

Is this parent's mailing address the same as yours?

Yes No

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Additional Parent

Relationship

Title

First Name

Last Name

E-mail Address

Phone Number

Is this parent's mailing address the same as yours?

Yes No

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Legal Guardian

Title

First Name

Last Name

E-mail Address

Phone Number

Is your guardian's mailing address the same as yours?

Yes No

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Family Links to Virginia Union University

Please list any family members who are currently attending or are alumni of Virginia Union University.

First Name

Last Name

Relationship

+ Add another family member

Your Information

Is this your first time here?

Your College Plans

Academic Interest