Family records | Emory Advancement & Alumni Engagement

We want to be in touch! The Emory Office of Parent and Family Advancement is looking forward to getting to know you better over the next four years. To ensure we can be a resource for you, provide you with updates, information and invitations to events and activities across the country, we ask that you take a few minutes to fill out this Family Record Form.

Please note that this form is to be completed by a parent or guardian and information will not be used outside of Emory University.

Student Information

Note: items with an asterisk(*) are required

First Name

Middle

Last Name

Preferred Fist Name

Birth Date

High School

Is the student transferring from another college?

Starting Class in

Parent/Guardian Information

The student is under the care of

Marital Status

Preferred address for all mailings

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Parent/Guardian 1

Prefix

First Name

Last Name

Preferred First Name

Gender identity

Other gender

Home Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Employer

Job Title

Business Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Undergraduate University

Year Graduated

Other degrees, class years and universities

Home Phone (or Primary)

Work Phone

Mobile Phone

Preferred E-mail

Work E-mail (if different from preferred)

Please list any business and civic boards and organizations to which Parent/Guardian 1 now belongs:

Please list any foundations, volunteer boards or boards of directors on which Parent/Guardian 1 has served, and where:

Please list any significant former professional positions Parent/Guardian 1 has held, and where:

Does Parent/Guardian 1 have a second address?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Parent/Guardian 2

Prefix

First Name

Last Name

Preferred First Name

Gender identity

Other gender

Home Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Employer

Job Title

Business Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Undergraduate University

Year Graduated

Other degrees, class years and universities

Home Phone (or Primary)

Work Phone

Mobile Phone

Preferred E-mail

Work E-mail (if different from preferred)

Please list any business and civic boards and organizations to which Parent/Guardian 2 now belongs:

Please list any foundations, volunteer boards or boards of directors on which Parent/Guardian 2 has served, and where:

Please list any significant former professional positions Parent/Guardian 2 has held, and where:

Does Parent/Guardian 2 have a second address?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Add additional Parent/Guardian

Parent/Guardian 3

Prefix

First Name

Last Name

Preferred First Name

Gender identity

Other gender

Home Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Employer

Job Title

Business Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Undergraduate University

Year Graduated

Other degrees, class years and universities

Home Phone (or Primary)

Work Phone

Mobile Phone

Preferred E-mail

Work E-mail (if different from preferred)

Please list any business and civic boards and organizations to which Parent/Guardian 3 now belongs:

Please list any foundations, volunteer boards or boards of directors on which Parent/Guardian 3 has served, and where:

Please list any significant former professional positions Parent/Guardian 3 has held, and where:

Does Parent/Guardian 3 have a second address?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Add additional Parent/Guardian

Parent/Guardian 4

Prefix

First Name

Last Name

Preferred First Name

Gender identity

Other gender

Home Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Employer

Job Title

Business Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Undergraduate University

Year Graduated

Other degrees, class years and universities

Home Phone (or Primary)

Work Phone

Mobile Phone

Preferred E-mail

Work E-mail (if different from preferred)

Please list any business and civic boards and organizations to which Parent/Guardian 4 now belongs:

Please list any foundations, volunteer boards or boards of directors on which Parent/Guardian 4 has served, and where:

Please list any significant former professional positions Parent/Guardian 4 has held, and where:

Does Parent/Guardian 4 have a second address?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country