Loyola University Chicago: Survey - Parent Information Form

Thank you for joining the Loyola Parent List-Serve!

You will recieve the quarterly Parent E-Newsletter, updates from campus as well as invitations to regional and on campus parent events.

Parent 1 Information

Please enter the contact information for Parent 1 below.

Employer:

Are you a Loyola Alumnus or Alumna?
Yes
No

If "No", what is your college / alma mater?

Parent 2 Information

Title:

First Name:

Middle:

Last Name:

Suffix:

Preferred E-mail Adress:

Occupation:

Employer:

Is this parent a Loyola Alumnus or Alumna?
Yes
No

If "No", what is their college / alma mater?

Please tell us about any Corporate, Civic, or Board Memberships that you, or your spouse, hold.

Student Information

*

First Name:

Last Name:

Other Loyola Student Information

Please enter any additional Loyola Student information below.