Parent and Family Information Form

Parent and Family Community Information Form

Thank you for your interest in Parent and Family Programs at UMass Boston! We hope to provide the best information and events to keep parent and family members connected to our great university.

Please provide your student's information for our records.

Student's First Name: Required Field

Student's Last Name Required Field

Student Gender:

Student Gender: Male
Female

Student's Major/Area of Study

In what year does your student plan to graduate? Required Field

Contact information: Parent/Family member 1

First Name: Required Field

Last Name: Required Field

Relationship to student: Required Field

Preferred email: Required Field

Address line 1: Required Field

Address line 2:

City:

State/Province: Required Field

Country:

If you are a UMass Boston alum, what is your year of graduation?

Would you like to receive our quarterly Parent and Family Connections e-newsletter? Required Field

Would you like to receive our quarterly Parent and Family Connections e-newsletter? Yes
No

Are you interested in volunteering as a Parent/Family Association Leader?

Are you interested in volunteering as a Parent/Family Association Leader? Yes
No

Contact information: Parent/Family member 2:

First Name:

Last Name:

Relationship to student:

Preferred email:

Address line 1:

Address line 2:

City:

State/Province:

Country:

If you are a UMass Boston alum, what is your year of graduation?

Would you like to receive our quarterly Parent and Family Connections e-newsletter?

Would you like to receive our quarterly Parent and Family Connections e-newsletter? Yes
No

Are you interested in volunteering as a Parent/Family Association Leader?

Are you interested in volunteering as a Parent/Family Association Leader? Yes
No

Additional Information

What programs or topics do you wish to learn more about?

If any other members of your family are alumni of UMass Boston, please provide their name and year of graduation:

If you have any other friends of family members who would like to receive our e-newsletter, please provide their full names and preferred email addresses:

Parent and Family Information Form

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