FRESH Basic Needs Hub: Collaboration Request Form 2017-2018
Thank you for your interest in collaborating with the FRESH Basic Needs Hub! 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.
Email address *
*What is your first & last name ? *
Your answer
What is your UCI email? (if applicable, if not, put in the primary email you'll be contacting us from) *
Your answer
What is your phone number? *
Your answer
What organization are you affiliated with? *
Your answer
What's your role/position? *
Your answer
What kind of collaboration are you requesting? *
Required
Please list potential dates and times for your collaboration *
Your answer
Please provide additional Comments/Program Details About your Request *
Your answer
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