Basic Needs Security Community Presentation Request Form
For any people, organizations, clubs, classes, and media teams that would like a UCB Basic Needs team representative to present on UC/UC Berkeley basic needs efforts or who have outreach questions. All requests should be made at least 2 weeks in advance. Approval of the requests will be based on coordinator availability and logistics involved. Thank you for your interest in learning about UCB Basic Needs initiatives!
Email address *
Organization/Class/Office Name, Point Person *
Your answer
Organization/Company/Office Point Person Email *
Your answer
Organization/Class/Office Point Person Phone Number *
Your answer
Point Person Preferred Pronouns (if comfortable sharing)
Your answer
Requested Presentation/Outreach Event Date/Time/Location + Description (format, topic, audience, etc.) *
Your answer
What would you like us to focus on?
What type of request is this?
Any additional details not mentioned above?
Your answer
Never submit passwords through Google Forms.
This form was created inside of UC Berkeley. Report Abuse