Join JBU's Family Mailing List

Please do not forward this form to another family. The link is unique to your student.

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JBU Student's First Name

JBU Student's Last Name

Student Birthdate

Please provide your email for a confirmation of form submission

Parent Information

Mother

Mother's First Name

Mother's Last Name

Mother is living

Yes

Mother's Marital Status

If the mother's spouse is the student's stepfather, what is his name?

Stepfather's First Name

Stepfather's Last Name

Mother's Home Phone (if parent is deceased, enter NA)

Mother's Mobile Phone

Mother's Email Address (if parent is deceased, enter NA)

Mother's Mailing Address

Country

Street

City

Region

Postal Code

Mother's Job Title

Mother's Company or Organization

Father

Father's First Name

Father's Last Name

Father is living

Yes

Father's Marital Status

If the father's spouse is the student's stepmother, what is her name?

Stepmother's First Name

Stepmother's Last Name

Father's Home Phone (if parent is deceased, enter NA)

Father's Mobile Phone

Father's Email Address (if parent is deceased, enter NA)

Is Father's mailing address different than Mother's?

Yes

Father's Mailing Address

Country

Street

City

Region

Postal Code

Father's Job Title

Father's Company or Organization

Grandparent Information

JBU's Grandparents' Day is coming in September! Please provide information so we can invite your grandparents.

Mother's Parents

My maternal grandparents share contact information (mailing address, email, phone)

My maternal grandparents do not share contact information

Maternal Grandmother First Name

Maternal Grandmother Last Name

Maternal Grandmother Email Address

Maternal Grandmother Phone Number

Maternal Grandmother Mailing Address

Country

Street

City

Region

Postal Code

Maternal Grandfather First Name

Maternal Grandfather Last Name

Maternal Grandfather Email Address

Maternal Grandfather Phone Number

Maternal Grandfather Mailing Address

Country

Street

City

Region

Postal Code

Maternal Grandparent Shared Email Address

Maternal Grandparent Shared Phone Number

Maternal Grandparent Shared Mailing Address

Country

Street

City

Region

Postal Code

Father's Parents

My paternal grandparents share contact information (mailing address, email, phone)

My paternal grandparents do not share contact information

Paternal Grandmother First Name

Paternal Grandmother Last Name

Paternal Grandmother Email Address

Paternal Grandmother Phone Number

Paternal Grandmother Mailing Address

Country

Street

City

Region

Postal Code

Paternal Grandfather First Name

Paternal Grandfather Last Name

Paternal Grandfather Email Address

Paternal Grandfather Phone Number

Paternal Grandfather Mailing Address

Country

Street

City

Region

Postal Code

Paternal Grandparent Shared Email Address

Paternal Grandparent Shared Phone Number

Paternal Grandparent Shared Mailing Address

Country

Street

City

Region

Postal Code