Parent Information Form

Contact Information

Relationship to Student

Parent First Name

Parent Last Name

Parent Email Address

Parent Home Phone

Parent Cell Phone

Would you like to receive text messages from SSU?

Yes

No

Mailing Address

Country

Street

City

Region

Postal Code

Are you a graduate of SSU?

Yes

No

Student Information

Student First Name

Student Last Name

Student Birthdate

Student Email (be sure to enter the students email address and not your own)

Student ID Number (if applicable)

High School Graduation Year