College Outreach Request

Event Primary Contact

Contact EMAIL Address

Contact FIRST Name

Contact LAST Name

Contact TITLE

Contact PHONE NUMBER

Organization Information

Organization Type

Population Served (select all that apply)

School/ Institution Name (Begin typing and select from auto-suggest list)

CEEB (hidden)

Community Based Organization (CBO) Name

Event Information

Event TITLE

Event TYPE

Grade Levels (Select All that Apply)

Event DATE

Event START Time

Event END Time

Estimated Number of Students Attending

Virtual Platform Details

VIRTUAL Event Platform / Location

VIRTUAL Event Link (If available)

In Person Event Details

*** Note: UCI Undergraduate Admissions is currently not attending "In Person" outreach events. However, we are leaving the ability to submit upcoming events for review as we continue to monitor the ever changing situation and guidelines***

Event LOCATION (School gym, Classroom, Etc.)

Event Location ADDRESS

Country

Street

City

Region

Postal Code

Comments or Additional Request:

Please Include Request Here