Professional Development/Visiting Student Form

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Degree

Masters

Academic Program of Interest

Concentration

First Certificate

Second Certificate

First Certificate

Certificate #1 ID

Certificate #2 ID

Doctorate

Academic Program of Interest

Certificate

Academic Program of Interest

Personal Information

First Name

Middle Name

Last Name

Suffix

Preferred Name, If Different Than Above

Former Last Name/Maiden Name

Birthdate

Sex

Gender Identity

Pronouns

Contact Information

Country

Home Address

City

State

Zip

Email Address

Email Type

Primary Phone

Primary Phone Type

Secondary Phone

Secondary Phone Type

Can We Contact You By Text Message? (Mobile Phone Number Required. Standard Messaging Rates May Apply.)

YesNo

What is Your Employment Status?

Please Explain

Employer Name

Employer Acct ID

My Employer is Not Listed

Not Listed

Current Employer Name (If Not Listed)

Position/Title

Employer Street Address

Employer City

Employer State

Employer Zip

For PA Educators, provide PPID (PA Professional Personnel ID)

Are you pursuing courses toward your LPC Licensure?

YesNo

Have you ever attended or taken a course (for credit) at LVC?

YesNo

What is the highest degree you have earned?

Institution at which you earned/will earn your Undergraduate degree?

Institution ID

Course Request Information

Term

Department

Course Name

Course Number

Course Section

Add second course request area?

YesNo

Course Request Information

Term

Department

Course Name

Course Number

Course Section

Add third course request area?

YesNo

Course Request Information

Term

Department

Course Name

Course Number

Course Section

Form Operation

Masters Academic Program ID

Doctorate Form Operation

Doctorate Academic Program ID

Certificate Form Operation

Certificate Academic Program ID

Additional Information

If you have any questions about this form or experience any issue with submission, please contact us at graduateadmission@lvc.edu.

Applicants are required to submit official undergraduate transcripts via electronic delivery service to graduateadmission@lvc.edu or to: Graduate Program Admissions Lebanon Valley College 101 N. College Ave. Annville PA 17003.

Current students and alumnus of Lebanon Valley College do not need to submit LVC transcripts.

Applicants must upload a resume and personal statement through the graduate program admissions portal after submission of this application. Additional documents may be required. Refer to the program’s admission information for a complete listing of required documents.

Applicants may elect to send additional documents to graduateadmission@lvc.edu (include your name and the program for which you are applying).

How Did You Hear About Lebanon Valley College?

Make it Official

Please check the box below to indicate your acceptance of the following:

I certify that all the information contained in this application is true and complete to the best of my knowledge
I understand that if the information I have provided is false, incomplete or inaccurate, my admission to Lebanon Valley College may be rescinded
I understand that all documents submitted to Lebanon Valley College will become the property of the institution and will not be returned to me
I understand the College expects all students to conduct themselves according to community values and the Student Conduct Code

I agree

Next Steps

To receive approval as a visiting student please forward an official transcript to graduateadmission@lvc.edu. If you are an LVC alumni or have completed graduate courses with us previously, your transcripts are on file.
Your request will be evaluated soon. Upon approval you will receive a confirmation email with additional information.