Parent/Guardian Signup Form


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. More information about this program can be found here. * Would you like to be included in the Out-of-state Regional Directory? Yes No This field is required.
Home Phone	Work Phone	Cell Phone
* Email Address
* Sign up for Parent Connect Newsletter: Yes No This field is required.
* Are you a Binghamton University Alumni? Yes No This field is required.		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
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

Tell us about your student

* Student First Name	* Last Name	* Class
* School	* Expected Graduation Year
* Major		* Degree type
* Living on campus? Yes No This field is required.		What Community
Email Address

* Do you have another child that is currently a student at Binghamton? Yes No This field is required.
Student First Name	Last Name	Class
School	Expected Graduation Year
Major		Degree type
Living on campus? Yes No This field is required.		What Community
Email Address

* Do you have any children who previously attended or graduated from Binghamton? Yes No This field is required.
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) This field is required.
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. More details Here
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 This field is required.
Notes

E-mail: families@binghamton.edu

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