Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Complete this form to RSVP for the Chancellor's Reception in San Jose on Saturday, March 5th, 2016. Prior to submitting the form, please review
event details below.
Event Date: Saturday, March 5th, 2016
Event Time: 11:00 am - 4:00 pm
Location: The Fairmont San Jose
Address: 170 S. Market St. / San Jose, CA / 95113
Phone: (408) 998-1900
For hotel reservations, please visit https://resweb.passkey.com/go/ucsbchancellorsreception2016 or call 800-346-5550 and reference being with the
"UCSB Chancellor's Reception" for ease of booking negotiated rates as available for your desired room type.
For parking, you can choose to valet at the hotel for $26.00 per day or visit www.sjdowntownparking.com for other options.
RSVP DEADLINE: Friday, February 19th, 2016 at 5pm
If you have questions, please contact:
Gina Gonzales (Admissions), 805-893-4518, gina.gonzales@sa.ucsb.edu
THANK YOU FOR YOUR PARTICIPATION!
Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Complete this form to RSVP for the Chancellor's Reception in San Jose on Saturday, March 5th, 2016. Prior to submitting the form, please review
event details below.
Event Date: Saturday, March 5th, 2016
Event Time: 11:00 am - 4:00 pm
Location: The Fairmont San Jose
Address: 170 S. Market St. / San Jose, CA / 95113
Phone: (408) 998-1900
For hotel reservations, please visit https://resweb.passkey.com/go/ucsbchancellorsreception2016 or call 800-346-5550 and reference being with the
"UCSB Chancellor's Reception" for ease of booking negotiated rates as available for your desired room type.
For parking, you can choose to valet at the hotel for $26.00 per day or visit www.sjdowntownparking.com for other options.
RSVP DEADLINE: Friday, February 19th, 2016 at 5pm
If you have questions, please contact:
Gina Gonzales (Admissions), 805-893-4518, gina.gonzales@sa.ucsb.edu
THANK YOU FOR YOUR PARTICIPATION!
UCSB Department [Required]
Please provide the department name as you would like it printed on staff name tags, space permitting.
Name of Primary Department Contact [Required]
Please provide your name as you would like it printed on your name tag, space permitting.
Title of Primary Department Contact [Required]
Please provide your title as you would like it printed on your name tag, space permitting.
Email Address of Primary Department Contact [Required]
Valid input:
- name@myschool.edu
Phone Number of Primary Department Contact [Required]
Please provide your phone number so that we can contact the you prior to the event, if necessary.
Valid input:
- must be 10-15 digits long and may include only numbers,
hyphens, and spaces.
Page 1 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Mobile Phone Number of Primary Department Contact [Required]
Please provide your cell phone number so that we can contact you on the day of the event, if necessary.
Valid input:
- must be 10-15 digits long and may include only numbers,
hyphens, and spaces.
Please share any comments here (optional):
IMPORTANT
Please provide requested information for any additional staff and student attendees in the pages to follow, if applicable.
Also, note that all staff and/or students who will be in attendance at the event on your department's behalf and are listed on this form will be provided a
lunch. There will be a vegetarian option.
If you have questions, please contact:
Admissions Visitor Center
Gina Gonzales, 805-893-4518, gina.gonzales@sa.ucsb.edu
THANKS AGAIN FOR YOUR PARTICIPATION!
(continue to next page for additional staff attendees or to submit form)
Page 2: Staff Attendee Information
Additional Staff
OPTIONAL
Please provide the contact information for any additional staff attendees from your department.
Staff #2 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #2 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #2 Email Address
Valid input:
- name@myschool.edu
Staff #3 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #3 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #3 Email Address
Valid input:
- name@myschool.edu
Staff #4 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Page 2 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Staff #4 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #4 Email Address
Valid input:
- name@myschool.edu
Staff #5 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #5 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #5 Email Address
Valid input:
- name@myschool.edu
Staff #6 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #6 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #6 Email Address
Valid input:
- name@myschool.edu
Staff #7 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #7 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #7 Email Address
Valid input:
- name@myschool.edu
Staff #8 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #8 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #8 Email Address
Valid input:
- name@myschool.edu
Staff #9 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Page 3 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Staff #9 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #9 Email Address
Valid input:
- name@myschool.edu
Staff #10 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Staff #10 Title
Please provide the title as you would like it printed on the name tag, space permitting.
Staff #10 Email Address
Valid input:
- name@myschool.edu
If you have questions, please contact:
Admissions Visitor Center
Gina Gonzales, 805-893-4518, gina.gonzales@sa.ucsb.edu
THANKS AGAIN FOR YOUR PARTICIPATION!
(continue to next page for student attendees or to submit form)
Page 3: Student Attendee Information
Student Attendees
OPTIONAL
Please provide the contact information for any student attendees from your department.
Student #1 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Student #1 Grade Level
Valid input:
- Select only one choice.
- must select a value.
[
[
[
[
] Freshman
] Sophomore
] Junior
] Senior
Student #1 Major
Please provide the major as you would like it printed on the name tag, space permitting.
Student #1 Email Address
Valid input:
- name@myschool.edu
Student #2 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Page 4 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Student #2 Grade Level
Valid input:
- Select only one choice.
- must select a value.
[
[
[
[
] Freshman
] Sophomore
] Junior
] Senior
Student #2 Major
Please provide the major as you would like it printed on the name tag, space permitting.
Student #2 Email Address
Valid input:
- name@myschool.edu
Student #3 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Student #3 Grade Level
Valid input:
- Select only one choice.
- must select a value.
[
[
[
[
] Freshman
] Sophomore
] Junior
] Senior
Student #3 Major
Please provide the major as you would like it printed on the name tag, space permitting.
Student #3 Email Address
Valid input:
- name@myschool.edu
Student #4 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Student #4 Grade Level
Valid input:
- Select only one choice.
- must select a value.
[
[
[
[
] Freshman
] Sophomore
] Junior
] Senior
Student #4 Major
Please provide the major as you would like it printed on the name tag, space permitting.
Student #4 Email Address
Valid input:
- name@myschool.edu
Student #5 Name
Please provide the name as you would like it printed on the name tag, space permitting.
Page 5 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form
Student #5 Grade Level
Valid input:
- Select only one choice.
- must select a value.
[
[
[
[
] Freshman
] Sophomore
] Junior
] Senior
Student #5 Major
Please provide the major as you would like it printed on the name tag, space permitting.
Student #5 Email Address
Valid input:
- name@myschool.edu
If you have questions, please contact:
Admissions Visitor Center
Gina Gonzales, 805-893-4518, gina.gonzales@sa.ucsb.edu
THANKS AGAIN FOR YOUR PARTICIPATION!
Page 6 of 6 · Chancellor's Reception 2016 @ San Jose, CA - UCSB Staff RSVP Form