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UCI Black Alumni Chapter Contact Form
As we are gearing up for our upcoming alumni events, we want to ensure that your contact information is updated! Please fill out the form with your latest contact information.
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Email
*
Your email
Full Name
*
Your answer
Phone number
Your answer
Additional Email Address
Your answer
Current City
*
Your answer
Current State
*
Your answer
UCI Affiliation
*
Current UCI Student
UCI Alumni
UCI Faculty/Staff
Community Member (no affiliation to UCI)
Other:
Required
Occupation Field
Law
Higher Education
Healthcare / Public Health
Hospitality
IT / Computer Science
Engineering
Arts
Business
Other:
Graduation year, if applicable (Please type N/A if not applicable)
Your answer
Major/minor, if applicable (Please type N/A if not applicable)
Your answer
Would you be interested in becoming a panelist, at any of our future events?
*
Yes
No
Maybe
Would you be interested in becoming a UCI Black Alumni Chapter board member in the future?
*
Yes
No
Maybe
How did you hear about us?
*
Social Media
Participated in a Black Alumni Chapter Event
UCI Alumni Association
Family or friend
Other:
Required
Additional Comments
Your answer
Send me a copy of my responses.
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