Midland Lutheran Admissions

Contact Admissions Form

Form Information

Following the submission of this form, you will receive an email confirming that Midland
Lutheran College has received this form. If you do not receive a confirmation email
please call the Office of Admissions at 800-642-8382 ext. 6501.

Personal Information

First Name:
Middle Name:
Last Name:
Maiden Name:
Preferred First Name:
Mailing Address:
City:
County:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Nonresident alien:
A person who is not a citizen or national of the United States and who is in this country on a visa or temporary basis and does not have the right to remain indefinitely.
Are you a Non-Resident Alien?

Additional Information

High School:
Graduation year:
What type of student are you?

Request Information

Please tell me more about:

How to apply for admission and financial aid
How I can talk to an admissions counselor and schedule a campus visit
Other (explain below)
My present career interest is:
Academic Interest:
What activities would you like to participate in while in college?
Sports you participated in during high school:
Questions or Comments