Outreach Event Request

First Name*

Last Name*

Title*

Phone Number

Email Address*

School or Organization Name *
If you are associated with a school or organization, please select the school or organization from the auto-suggestion drop-down menu.

Event Details (External Questions)

Type of Event*

Event Audience*

RSVP Date*

Anticipated Number of Students*

Is Event Virtual

Yes

No

Event Date*

Estimated number of teachers / chaperones

Earliest time of arrival
Enter time in the format hh:mm am/pm

End Time

Select your preferred visit date.

Select an alternate visit date.

Select another alternate visit date.

Would you like to provide any additional details? (ie. ADA accommodations)

If Approved
If we are able to accommodate your group, our office will follow up with you within 7 business days. You will be required to provide additional information in a timely manner. Failure to do so may result in the cancellation of your tour due to insufficient information. Additionally, you will be responsible for ensuring that each student is registered at least one week prior to the scheduled tour date. If this requirement is not met, your tour may be canceled.

I acknowledge

College Fair Title *

College Fair/Presentation Location Address *

Country

Street

City

Region

Postal Code

Is there a registration fee? *

Yes

No

Fee Amount ($) *

Payment Instructions *

How do we register for your event?*

Paper Registration: Paper form must be completed to register for the event.
Online Registration: Registration can be completed online.
Email Registration: To register, we must email a specific person/organization.

Registration Form *

Registration Web Link*

Contact First & Last Name*

Email*

Presentation Type

Please Describe the Type of Presentation

Summary of Presentation Request

Presentation Audience

Please Describe Presentation Audience

Time Length of Presentation

Are you UC San Diego Staff / Faculty or Internal Outreach Partner*

Yes

No

If you are not a staff member / faculty or internal outreach partner, please do not use the following drop-down menu.

First*

Last*

Email Address*

What department / unit / internal outreach partner