The information you provide will be used by University Advancement and Student Affairs
to invite parents to participate in UCI events and programs.

I.  Student Information
Admission ID: Student ID:
Title: First Name:  Last Name: Middle Initial:
II. Parent Home Information
Relation:  
Title:  First Name: Last Name: Middle Initial:  Suffix:
Street: City: State: Zip code:
Country: Phone:   Only numbers e.g. 9495553344
Email: Language spoken at home:
Parent Education:
Please enter Name as Student:
Last College Attended: Degree:
Parent Business:
Company:  Occupation:  Job Title:
Street: City: State: Zip code:
Country: Phone: Only numbers e.g. 9495553344
III. Additional Parent Information
Check here if home information is same as above.
Relation: 
Title: First Name: Last Name: Middle Initial:   Suffix:
Street: City: State:   Zip code:
Country: Phone: Only numbers e.g. 9495553344
Email: Language spken at home:
Parent Education:
Please enter name while a Student:
Last College Attended: Degree:
Parent Business:
Company: Occupation: Job Title:
Street: City: State: Zip code:
Country: Phone: Only numbers e.g. 9495553344
IV. Family Information
List any family members who have attended or are currently attending UCI:
First Name: Last Name: Year Graduated: Relation:
First Name: Last Name: Year Graduated: Relation:
First Name: Last Name: Year Graduated: Relation: