Parent Information Form

UCI Anteater Family information

Welcome to the UCI Anteater family!

By completing the form below and updating your contact information, you will receive campus alerts, news and updates, as well as information about campus events and programs. The information that you provide will remain confidential.

Student First Name:

Student Last Name:

Student Birth Date:

Student ID Instructions:

The student ID is a 8 digit number provided on the Student Intent to Register Form, and can also be located on the Welcome Packet materials provided upon acceptance notification. Please email connectsupport@uci.edu if you have any questions regarding this information.

Student ID:

Expected Graduation Year:

School

Major

Application Term:

Application Year:

Parent/Guardian 1 Information

Relationship to Student:

First Name:

Last Name:

Email:

Phone Number:

Address:

City:

State

Zip Code:

Country

Are you an alum of UCI?

UCI Class Year:

Language at home:

Parent/Guardian 1 Business Information

Employer:

Job Title:

2nd Parent/Guardian?:

YesNo

2nd Parent/Guardian Information

First Name:

Last Name:

Email:

Phone Number:

Address :

Same Address as Parent/Guardian 1Different Address from Parent/Guardian 1

Address:

City:

State

Zip Code:

Country

Address:

City:

State:

Zip Code:

Country:

Employer:

Job Title:

Would you like to be contacted by a current parent?

YesNo