Description: this form is for UCSB faculty (or affiliated staff) who wish to contribute an outreach activity or presentation to the catalog. (Please note: If you would like to remove an entry from the catalog, please complete all of the fields marked with a red asterisk (*).

New Entry
Revised Entry
Remove Entry

Lead Presenter's Contact Information:

First Name:
*

Last Name
*

Department:


Phone:


Email Address:
*

Presentation/Activity Title:
*

Intended Grade Level(s):


Please provide us with a brief description of your presentation or activity:


Please let us know of any scheduling requirements that you may have (e.g. only available specific quarters, days of the week, etc.):


Event scheduling to be handled by:
College of Letters and Science
other

If "other", please provide contact information:

Name:


Email: