University of California - Santa Barbara

Parent Form

I would like to receive information on UC Santa Barbara Parent Event.

Do you come to campus regularly?

Parent 1

Title:

First Name:

Middle Name:

Last Name:

Suffix:

Maiden Name:

Marital Status:

Are you a UCSB Alumni?:

UC Alum ?:

College Attended:

Relationship to Student:

Parent 2

Title:

First Name:

Middle Name

Last Name:

Suffix:

Maiden Name

Marital Status:

UCSB Alumni:

UC Alum

College Attended:

Relationship to Student:

Preferred Mailing Address for Parent 1

Preferred Address 1:

Preferred Address 2:

Preferred Address 3:

Preferred City:

Preferred State:

Preferred Zip Code:

Country:

Preferred Phone Number:

Email:

Secondary Email:

Preferred Mailing Address for Parent 2

Address 1:

Address 2:

Address 3:

City:

State:

Zip Code:

Country:

Preferred Phone Number:

Email:

Secondary Email:

Student(s)

Student Last Name:

Student Middle Name:

Student First Name:

Student Grad Year:

Do you have more than one child attending UC Santa Barbara?

Second Student Last Name:

Second Student Middle Name:

Second Student First Name:

Second Student Grad Year:

Business/Employment

Optional: Please provide Business Information.

Status - I am:

Business Name:

Business Street 1:

Business Street 2:

Business City:

Business State:

Business Phone:

Business Email:

Comments