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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?
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*
Country
Street
City
Region
Postal Code
Have you visited UCI?
Yes
No
Are you a UCI alum?
Yes
No
Optional Information:
When did you start working for your current organization? (HIDDEN)
January
February
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2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
When did you start working for your current organization?
(MM-dd-yyyy)
Which populations of students do you serve?
Freshman
International Students
LGBTQ
Low Income
Military / Veterans
Transfer
TRIO
Underrepresented Students
Upward Bound
Scheduling:
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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