Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

Transcription

1 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form Complete this form to RSVP for the Chancellor's Reception in Costa Mesa on Saturday, March 19th, Prior to submitting the form, please review event details below. Event Date: Saturday, March 19th, 2016 Event Time: 11:00 am - 4:00 pm Location: Westin South Coast Plaza Address: 686 Anton Blvd. / Costa Mesa, CA / Phone: (714) For hotel reservations, please check area hotels for availability and rates (nearby options below). Please note that we do not have a negotiated rate at any of these hotels. Costa Mesa Marriott 500 Anton Blvd. / Costa Mesa, CA / (714) Hotel Irvine Jamboree Rd. / Irvine, CA / (949) Residence Inn Costa Mesa Newport Beach 881 Baker St. / Costa Mesa, CA / (714) Courtyard Santa Ana Orange County 8 MacArthur Pl. / Santa Ana, CA / (714) Although the Westin South Coast Plaza does not have overnight rooms available on the evening prior to our event, you can still choose to valet at the hotel or self-park in the adjacent lot on the day of the event. RSVP DEADLINE: Friday, February 19th, 2016 at 5pm Gina Gonzales (Admissions), , gina.gonzales@sa.ucsb.edu THANK YOU FOR YOUR PARTICIPATION! Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form Complete this form to RSVP for the Chancellor's Reception in Costa Mesa on Saturday, March 19th, Prior to submitting the form, please review event details below. Event Date: Saturday, March 19th, 2016 Event Time: 11:00 am - 4:00 pm Location: Westin South Coast Plaza Address: 686 Anton Blvd. / Costa Mesa, CA / Phone: (714) For hotel reservations, please check area hotels for availability and rates (nearby options below). Please note that we do not have a negotiated rate at any of these hotels. Costa Mesa Marriott 500 Anton Blvd. / Costa Mesa, CA / (714) Hotel Irvine Jamboree Rd. / Irvine, CA / (949) Page 1 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

2 Residence Inn Costa Mesa Newport Beach 881 Baker St. / Costa Mesa, CA / (714) Courtyard Santa Ana Orange County 8 MacArthur Pl. / Santa Ana, CA / (714) Although the Westin South Coast Plaza does not have overnight rooms available on the evening prior to our event, you can still choose to valet at the hotel or self-park in the adjacent lot on the day of the event. RSVP DEADLINE: Friday, February 19th, 2016 at 5pm Gina Gonzales (Admissions), , 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. Title of Primary Department Contact [Required] Please provide your title as you would like it printed on your name tag, space permitting. Name of Primary Department Contact [Required] Please provide your name as you would like it printed on your name tag, space permitting. Address of Primary Department Contact [Required] 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. - must be digits long and may include only numbers, hyphens, and spaces. 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. - must be digits long and may include only numbers, hyphens, and spaces. Please share any comments here (optional): Admissions Visitor Center Gina Gonzales, , gina.gonzales@sa.ucsb.edu THANKS AGAIN FOR YOUR PARTICIPATION! (continue to next page for additional staff attendees or to submit form) IMPORTANT Please provide requested information for any additional staff and student attendees in the pages to follow, if applicable. Page 2 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

3 Also, note that all staff, faculty 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. Page 2: Staff Attendee Information Additional Staff OPTIONAL Please provide the contact information for any additional staff attendees from your department. Staff #2 Name Staff #2 Title Staff #2 Address Staff #3 Name Staff #3 Title Staff #3 Address Staff #4 Name Staff #4 Title Staff #4 Address Staff #5 Name Staff #5 Title Staff #5 Address Page 3 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

4 Staff #6 Name Staff #6 Title Staff #6 Address Staff #7 Name Staff #7 Title Staff #7 Address Staff #8 Name Staff #8 Title Staff #8 Address Staff #9 Name Staff #9 Title Staff #9 Address Staff #10 Name Staff #10 Title Staff #10 Address Page 4 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

5 Admissions Visitor Center Gina Gonzales, , 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 Student #1 Grade Level Student #1 Major Student #1 Address Student #2 Name Student #2 Grade Level Student #2 Major Student #2 Address Student #3 Name Page 5 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

6 Student #3 Grade Level Student #3 Major Student #3 Address Student #4 Name Student #4 Grade Level Student #4 Major Student #4 Address Student #5 Name Student #5 Grade Level Student #5 Major Student #5 Address Admissions Visitor Center Gina Gonzales, , Page 6 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form

7 THANKS AGAIN FOR YOUR PARTICIPATION! Page 7 of 7 Chancellor's Reception Costa Mesa, CA - UCSB Staff RSVP Form