Parents & Families Association Membership Form

Primary Family Member Information

Please complete the following:


*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
	You may receive periodic communications from Kent State University.

*

Question - Required - Relationship to Student(s):

Question - Not Required - Are you a Kent State graduate: Yes
No

Question - Not Required - Degree Year (if applicable)

Question - Not Required - Are you currently employed by Kent State University: Yes
No

Second Family Member Information

Question - Not Required - Full Name:

Question - Not Required - Relationship to Student(s)

Question - Not Required - Are you currently employed by Kent State University: Yes
No

Question - Not Required - Degree Year (if applicable)

Question - Not Required - Are you a Kent State graduate: Yes
No

Student Information

*

Question - Required - Full Name:

*

Question - Required - Kent State University Email (@kent.edu)

*

Question - Required - Student's Class Status:

Question - Not Required - Please list other family members attending Kent and their relationship:

(Maximum response 255 chars, approx. 5 rows of text)