Interest Form- Take Back The Night
Take Back the Night is an event-based around reclaiming the night as a safe place and putting an end to sexual assault, domestic violence, and stalking.

We are accepting submissions to create a collage of people’s work to showcase during the event. People who participate are eligible to receive a gift card!!

If you are interested in submitting content for our Virtual Take Back The Night event please fill out this form. We will then reach out via email to provide a link for your content to be submitted anytime before the deadline. Thank you for being a part of our event, we look forward to seeing your work!
 
Participation is open to Students, Staff, Faculty, and Affiliates!
If you have any questions please email us at ucmcare@ucmerced.edu
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Name (First and Last) *
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What type of performance are you planning on submitting?
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Would you like to remain anonymous to the public? *
What is your relationship with UC Merced *
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