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Counselor Contact Update Form
Thank you for your interest in UC Irvine!
Please fill out the form below to stay connected to the UCI Office of Undergraduate Admissions for important information about events on campus and in your area.
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Contact Information:
Salutation
Dr.
Mr.
Mrs.
Ms.
First Name*
First Name (Hidden)
Last Name*
Last Name (Hidden)
Display Name (Hidden)
Email Address*
Email Address (Hidden)
Device - Type (Hidden)
Primary Phone
Mobile Phone
Evening Phone
Email Address
UCI Email
Device - Value (Hidden)
Office Phone Number*
Does your phone require an extension?
Does your phone require an extension?
Yes
No
Extension
Phone Number (Hidden)
Phone Number No Extension (Hidden)
Device - Type (Hidden)
Primary Phone
Mobile Phone
Evening Phone
Email Address
UCI Email
Device - Value (Hidden)
Device - Value No Extension (Hidden)
Organization Information:
Organization Type*
High School
Community College
Community Based Organization
Independent Counselor
School / Institution
School / Institution Name*
CEEB(Hidden)
Office / Department
Working Title*
Community Based Organization (CBO)
CBO Name*
CBO Verification Name (hidden)
CBO Verification CEEB (hidden)
Independent Counselor
Organization*
Independent Counselor Verification Name (hidden)
Independent Counselor Verification CEEB (hidden)
Organization Address*
Organization Address*
Country
Street
City
Region
Postal Code
Have you visited UCI?
Have you visited UCI?
Yes
No
Are you a UCI alum?
Are you a UCI alum?
Yes
No
Optional Information:
When did you start working for your current organization? (HIDDEN)
When did you start working for your current organization? (HIDDEN)
January
February
March
April
May
June
July
August
September
October
November
December
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
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2014
2015
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2017
2018
2019
2020
2021
2022
2023
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2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
When did you start working for your current organization?
(MM-dd-yyyy)
Which populations of students do you serve?
CalWorks
Disability Student Services
Dreamers/Undocumented Students
EOPS/CARE
Foster Youth
Freshman
Guardian Scholars
Honors
International
International Students
LGBTQ
Low Income
MESA
Military / Veterans
Puente
TANF
Transfer
TRIO
TRIO
Umoja
Underrepresented Students
Upward Bound
Veterans
Scheduling:
Are you the contact at your organization who schedules college reps to visit your school?
Are you the contact at your organization who schedules college reps to visit your school?
Yes
No
How does your school schedule college reps to visit?
Slate.org
Rep Visits
Online Scheduler
Email
Phone
Other
Please provide scheduling website:
Please provide information on your scheduling method preferences:
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