Parent/Guardian Signup Form

Please activate your family status by filling out this form to receive family benefits, including connections to campus professionals, access to online resources, the Parent Connect monthly newsletter, campus event and volunteer opportunities, and eligibility to serve on the Parent Leadership Council (PLC)

* Parent 1 First Name

* Last Name

* Relationship to Student

* Address

* Country

* City

* State

* Zip
We have an Out-of-State Regional Directory which will be emailed to all opt-in participants from the Parent and Family Program office in the first month of each semester (fall and spring). Updates to the directory will be made once a semester prior to distribution.

* Would you like to be included in the Out-of-state Regional Directory? Yes No

Home Phone

Work Phone

Cell Phone

* Email Address

* Sign up for Parent Connect Newsletter: Yes No

* Are you a Binghamton University Alumni? Yes No

If different, name while a student
Year Graduated

Major

Degree

Parent 2 First Name

Last Name

Relationship to Student

Address

Country

City

State

Zip

Home Phone

Work Phone

Cell Phone

Email Address

Are you a Binghamton University Alumni? Yes No

If different, name while a student
Year Graduated

Major

Degree

Tell us about your student
* Student First Name

* Last Name

* Class

* School

* Expected Graduation Year

* Major

* Degree type

* Living on campus? Yes No

What Community

Email Address

* Do you have another child that is currently a student at Binghamton? Yes No

Student First Name

Last Name

Class

School

Expected Graduation Year

Major

Degree type

Living on campus? Yes No

What Community

Email Address

* Do you have any children who previously attended or graduated from
Binghamton? Yes No

First Name

Last Name

Graduation Year

School

Major

Degree type

* We need your help! Would you be willing to be a volunteer?
Yes No (click Yes to see volunteer options)

Tell us what you're interested in! Please check all that apply.
Speaking and answering questions from new Binghamton parents/family members about your experience as a Binghamton parent either on campus at Admissions events, or through electronic means

Hosting a Binghamton student as an intern at your place of employment. (Please state place of employment and city in the comment section at the bottom of this form.)

Hosting a site visit at your place of employment. (Please state place of employment and city in the comment section at the bottom of this form.)

Providing feedback on Parent and Family surveys emailed to you (ex. future event ideas, webinar topics, Family Weekend speakers, etc.)

Joining the Binghamton Parents Leadership Council (PLC). *Requires financial contribution.

Volunteering for parent and family events whether in Binghamton on in your hometown

Other / More information

* Any additional informaton or notes to share? Yes No

Notes

E-mail: families@binghamton.edu

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