JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Inquiry for SMI Information
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
UCR Student ID#
*
Your answer
UCR email
*
Your answer
Declared Major
*
Your answer
Which subject area are you interested in teaching? (select one)
*
Science
Math
Who or what referred you to contact SMI?
*
Your answer
Indicate all applicable time blocks that match your general weekly availability. Your response will be used for setting up a 30-minute informational session. Please move the "slider" bar to view/all time options.
*
10:00 am-10:30 am
10:30 am-11:00 am
11:00 am-11:30 am
11:30 am-12:00 pm
12:00 pm-12:30 pm
12:30 pm-1:00 pm
1:00 pm-1:30 pm
1:30 pm-2:00 pm
2:00 pm-2:30 pm
2:30 pm-3:00 pm
Not available during any of these times
Monday
Tuesday
Wednesday
Thursday
Friday
10:00 am-10:30 am
10:30 am-11:00 am
11:00 am-11:30 am
11:30 am-12:00 pm
12:00 pm-12:30 pm
12:30 pm-1:00 pm
1:00 pm-1:30 pm
1:30 pm-2:00 pm
2:00 pm-2:30 pm
2:30 pm-3:00 pm
Not available during any of these times
Monday
Tuesday
Wednesday
Thursday
Friday
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
