Information Request Form

Thank you for your interest in West Virginia State University! To learn more about WVSU, please
complete this form, and a member of our team will contact you. Or, if you are ready to start an
admission application, please click here. Go State!

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Personal Information

First Name*

Last Name*

Preferred First Name

Birthdate*

Contact Information

Email Address*

Confirm Email Address*

May we contact you via text messaging?*

Yes

No

Cell Phone Number*

Would you like to provide a mailing address?*

Yes

No

Mailing Address*

Country

Street

City

Region

Postal Code

Academic Information

How will you be applying?*

First-Time Freshman

Transfer

Intended Start Term*

High School*
(If you cannot locate your school in the dropdown, please type the name, city and state of the school.)

Current or Last Attended College/University*
(If you cannot locate your school in the dropdown, please type the name, city and state of the school.)

Academic Interest*