Family Information Form

Thank you for filling out the WPI Family Information Form. All of the information you provide is voluntary and will be used only for communication and other internal purposes of WPI. (Read our Privacy statement for more information.)

If you prefer, you can download a PDF version of this form and mail it to WPI, Office of University Advancement, Attn: Ann Tomassini, 100 Institute Road, Worcester, MA, 01609-2280.

For additional assistance, please contact us at atomassini@wpi.edu or call +1-508-831-5949.

* Denotes a required field

Student

Full name *
Home address (street) *
City *
State *
ZIP *
Home phone *
High School Attended

Parent 1

Name *
Home address (street) *
Email address *
City *
State *
ZIP *
Home phone *
College attended
Degree
Class year
Additional education
Job title *
Company *
Business address (street)
City
State
ZIP
Business phone
Professional, civic, social affiliations
Volunteer Opportunities * Communications / Newsletter
Special Events and Hospitality
Membership
Advancement

Parent 2

Name *
Home address (street) *
Email address *
City *
State *
ZIP *
Home phone *
College attended
Degree
Class year
Additional education
Job title *
Company *
Business address (street)
City
State
ZIP
Business phone
Professional, civic, social affiliations
Volunteer Opportunities * Communications / Newsletter
Special Events and Hospitality
Membership
Advancement
Type in the following two words
 
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