Parent Information Form

If you haven't already supplied Willamette with this information, or if your information has changed, please fill out the form below.

Student Information

Name

Date of Birth

High School

Type of High SchoolPublicPrivate

The student isNewTransfer

Parent/Guardian 1 Information

Name

Address

Occupation/Title

Business Name and address

Home Phone

Business Phone

Cell Phone

Preferred Email

Board Memberships and/or Affiliations

Civic Involvement

College(s) Attended/Degree/Year

Graduate School(s) Attended/Degree/Year

Parent/Guardian 2 Information

Name

Address

Occupation/Title

Business Name and Address

Home Phone

Business Phone

Cell Phone

Preferred Email

Board Memberships and/or Affiliation

Civic Involvement

College(s) Attended/Degree/Year

Graduate School(s) Attended/Degree/Year

General Information

Other Willamette family members? Please list name, class year, relationship

Are you interested in hearing about volunteer opportunities at Willamette?YesNo

Willamette University

Alumni and Parent Engagement

Address

900 State Street

Salem Oregon 97301 U.S.A.

Phone

503-375-5304