Parent and Family Council Interest Form

First Parent/Guardian Information

First Name

Last Name

Title

Marital Status

Email Address

Phone Type

Home

Work

Mobile

Phone Number

Street Address

Street Address 2

City

State

Zip Code

Relation to Student

Are you a Rider Alumnus?

Yes

Rider Class Year

Employment Information

Organization/Company

Job Title

Would you like to register another parent/guardian?

Yes

Second Parent/Guardian Information

First Name

Last Name

Title

Marital Status

Email Address

Phone Type

Home

Work

Mobile

Phone Number

Street Address

Street Address 2

City

State

Zip Code

Relation to Student

Are you a Rider Alumnus?

Yes

Rider Class Year

Employment Information

Organization/Company

Job Title

Rule

First Student Information

Student First Name

Student Last Name

Expected Graduation Year

Bronc ID, if available

Do you have additional students attending Rider University?

Yes

Second Student Information

Student First Name

Student Last Name

Expected Graduation Year

Bronc ID, if available

Third Student Information

Student First Name

Student Last Name

Expected Graduation Year

Bronc ID, if available

Areas of Involvement:

I would like to join the Parent and Family Council: The council helps educate and connect parents to Rider and seeks to encourage families to support the University through philanthropic generosity. Members of this council are invited to special events and council meetings with administrators.

I would like to be a Parent & Family Ambassador: Our ambassadors serve as volunteers for the University, creating a community of engaged and dedicated parents and families. Ambassadors are invited to Rider University’s Volunteer Recognition event to thank you for your dedication and assistance.

Please specify

Questions or comments

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