UCI Home Page UCI Libraries Home Page UCI Home Page

DACE Program Request Form

Day At College Experience

Note: * = Required fields
* First name:
* Last name:
* Email address:
Phone number:
* School county:
* School district:
* School name:
*Grade level:
Subject area:
Preferred dates for visit:
* First choice:
Second choice:
Third choice:
* Number of participants:
* What are your
learning objectives
for the requested
visit?:
Additional comments or questions:
How did you
hear about the
DACE Program?
Or other source:
Have you participated in the DACE program before ? Yes No
    

 

For more information, contact:
Melanie Sellar
(949) 824-9214
msellar@uci.edu


Back  Back
Top of Page