Directory Apply Give

Outside Workshop Program Form

In order to receive credit, please fill out all the sections on the form.

Scholars should receive an e-mail confirmation of submission of the form displaying the following information that was submitted:

form.antibot { display: none !important; } You must have JavaScript enabled to use this form.

1 Start 2 Complete

Today's Date *

Month

Day

Year

First Name *

Last Name *

UC Merced Student ID # *

UC Merced E-mail (@ucmerced.edu) *

1st Year

2nd Year

Other...

Year in the Program Other...

Name of the Workshop *

Name of the Host or the Department Presenting the Workshop *

A brief 3-5 sentence summary of the information learned *

Leave this field blank

Resources