Address Form

Current parent address form

If your student is a current or new Bluffton University student, please provide parent and/or guardian contact information so that we may better communicate with you. If you have questions, do not hesitate to contact parentinfo@bluffton.edu.

*Note that completion of this form does not grant you access to your student's FERPA protected date. To gain that access, your student would need to complete the Give Permission To My Data (FERPA).

If you see this don't fill out this input box.

Student's first name*

Student's middle name*

Student's last name*

Student's birthdate MM/DD/YYYY*

Parent/Guardian marital status

Married/Remarried

Widowed

Divorced/Separated

Single

Parent/Guardian #1

Parent/Guardian #1 gender

Parent/Guardian #1 birthdate MM/DD/YYYY

Parent/Guardian #1 address

Parent/Guardian #1 address line 2

Parent/Guardian #1 city

Parent/Guardian #1 state

Parent/Guardian #1 zip

Parent/Guardian #1 country

Parent/Guardian #1 email

Parent/Guardian #1 home phone

Parent/Guardian #1 cell phone

Parent/Guardian #2 first name

Parent/Guardian #2 middle name

Parent/Guardian #2 last name

Parent/Guardian #2 gender

Male

Female

Prefer not to stay

Parent/Guardian #2 birthdate MM/DD/YYYY

Parent/Guardian #2 address the same as above

Yes

Parent/Guardian #2- if different than above

Parent/Guardian #2 address line 2

Parent/Guardian #2 city

Parent/Guardian #2 state

Parent/Guardian #2 zip

Parent/Guardian #2 country

Parent/Guardian #2 email

Parent/Guardian #2 home phone

Parent/Guardian #2 cell phone

Step-father's name (if applicable)

Step-mother's name (if applicable)

Questions or comments