First Name: Last Name:
City: State: Zip Code:
|High School: Year in school:
If senior, have you applied to Viterbo?
Name of high school teacher we could contact for a reference:
HS GPA: Composite ACT:
Career interests: (if unsure, put undecided)
Science and/or math classes you are currently taking:
|Can you attend the entire day - 9 a.m.–4 p.m.?