UCI Basic Needs Center Collaboration Request Form 2023-2024
Thank you for your interest in collaborating with the UCI Basic Needs Center! We are excited to potentially create a partnership with you.

Please fill out this form to provide us with more information about who you are and what kind of collaboration you're requesting. We prefer that when requesting a collaboration, you let us know at least two weeks in advance so that we can have sufficient time to plan, organize, and market (if need be). Any request submitted less than two weeks of collaboration date is not guaranteed to be considered on time.
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First & Last Name *
UCI Email (If not affiliated with UCI, please use your primary email you'll be using to communicate with us) *
Phone Number *
What organization are you affiliated with? *
What is your role/position? *
What kind of collaboration are you requesting? *
Required
If you selected "Class Pitch/Presentation" from the previous section, please specify which one's you're interested in *
Required
Please list potential dates and times for your collaboration. *
For scheduling purposes (if possible), we encourage you to choose a time between 8am-5pm if you're requesting a presentation or workshop from our team. If that doesn't work, that's okay! We'll do our best to accommodate your request.
Please provide additional comments/program details about your request. *
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