Chancellor's Undergraduate Internship Program (CUIP
Selection Process Survey
Bright Beginnings, Bright Futures
Bright Beginnings, Bright Futures
First Name *
Your answer
Last Name *
Your answer
First name for Name Tag *
Your answer
Address: *
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City *
Your answer
State: (2 letter abbreviation) *
Your answer
Zip: *
Your answer
Phone Number: *
(###)-###-####
Your answer
Email: *
Your answer
College *
Your answer
Student ID # *
Your answer
Major *
Your answer
Projected year of graduation *
Your answer
What is your Gender (Optional)?
What is your ethnicity (optional)?
Your answer
Will you be able to attend the required CUIP Class held on Monday nights from 5:20-6:55 p.m. for Fall, Winter, and Spring quarters? *
Will you be a full time student for the entire academic year (Fall, Winter, and Spring quarters)? *
Select your first choice of CUIP positions for which you were interviewed: *
Your answer
Second Choice
Your answer
Third Choice
Your answer
Fourth Choice
Your answer
How did you hear about CUIP?
Please check all that apply:
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