Parents Leadership Council Application

Parent/Guardian Name:*

First Name

Last Name

Student's Name*

First Name

Last Name

Your Relation to Student*

Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Email*

Your Occupation

Title

What experiences, professional skills and ideas are you bringing to Seton Hall Parents Leadership Council?*

What do you expect from serving on the Council?*

I confirm that I will support the mission of Seton Hall Parents Leadership Council and fulfill my commitments. My term on the Parent Council will end with my student’s graduation, lack of fulfillment of my commitments or by request of Seton Hall administration.*

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Date