CONCORDIA UNIVERSITY IRVINE PARENT INFORMATION FORM



CONCORDIA UNIVERSITY IRVINE PARENT INFORMATION FORM | |

|Please make additional copies if necessary. |

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|Student’s Name: CUI Class: 2014, 2013, 2012, 2011 (circle one) |

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|Student’s High School: Student’s Home Church: |

|Parent Information: |

|Relationship to student: |

|( Mother ( Stepmother ( Grandmother ( Guardian ( Father ( Stepfather ( Grandfather ( Guardian |

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|Home Address: Home Address: |

|Street: Street: |

|City/State/Zip: City/State/Zip: |

|Home Phone: Home Phone: |

|Cell Phone: Cell Phone: |

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|Employer: Employer: |

|Street: Street: |

|City/State/Zip: City/State/Zip: |

|Work Phone: Work Phone: |

|Position title: Position title: |

|( check if matching gift company  check if company offers internships ( check if matching gift company  check if company offers internships |

|Preferred email* Preferred email* |

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|**Occupation code: **Industry code: **Occupation code: **Industry code: |

|*provides for quick and easy communication for CUI **see back for codes |

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|Corporate/Foundation non-profit board affiliations (please do not abbreviate) |

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|Organization: City/State |

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|Organization: City/State |

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|Organization: City/State |

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|ARE YOU INTERESTED IN BECOMING INVOLVED WITH ANY OF THE FOLLOWING ACTIVITIES? |

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|( PARENT – TO – PARENT Participate on panels, help develop interaction among parents. |

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|( CAREER DEVELOPMENT Offer internships, employment opportunities for students; participate in career panels |

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|( LOCAL EVENTS Sponsor dinners or summer send offs, or represent parents at regional alumni programs. |

| Serve as volunteers at admissions events, Fall Weekend or Commencement. |

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|Would you be willing to host an activity in your home or other space? ( Yes ( No Optimal number of guests _______ |

|We welcome your suggestions about other ways in which your talents and experience might enrich the Concordia community. |

|Please tell us about any special interests or expertise you might share. |

|____________________________________________________________________________________________________ |

Which range most closely approximated your current family income? (optional)

( Under $30,000 ( 40,000 – 59,000 ( 75,000 – 124,999 ( 200,000 – 349,000 ( 500,000 – 999,999

( 30,000 – 39,000 ( 60,000 – 74,999 ( 125,000 – 199,999 ( 350,000 – 499,000 ( 1,000,000 and above

Please return this questionnaire within two weeks.

Fax to 949-854-6888, Download a copy at cui.edu/people/parents , email to family@cui.edu or mail to:

Concordia University Foundation

1530 Concordia West

Irvine, CA 92612

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