UCI Volunteer Center New Agency Request

Student Affairs Office of the Dean of Students

New Agency Request Form

If you represent a community agency that would like to work with UCI students and be listed in our database of service opportunities, please make sure you have read our AGENCY AGREEMENT, and then complete the following web form...

* AGENCY / ORGANIZATION NAME
* CONTACT PERSON
CONTACT TITLE
CONTACT E-MAIL ADDRESS
STREET ADDRESS 1
STREET ADDRESS 2
CITY, STATE, ZIP
* TELEPHONE
FAX
WEBSITE ADDRESS
BUSINESS HOURS / HOURS OF OPERATION
DISTANCE FROM UCI
* AGENCY DESCRIPTION / MISSION
DESCRIBE SOME OPPORTUNITIES YOU WOULD OFFER TO UCI STUDENTS AND/OR WHAT THEY CAN DO
REQUIREMENTS/RESTRICTIONS
AGENCY CATEGORY / CATEGORIES CATEGORIES HELP STUDENT STUDENTS FIND OPPORTUNITIES IN THEIR FIELDS OR AREAS OF INTEREST. PLEASE CHECK ANY THAT STRONGLY APPLY TO YOUR AGENCY OR ORGANIZATION...	Abuse Animals Arts and Culture Children and Youth Elderly Care Environment and Nature Health and Wellness Hunger and Homelessness Legal Aid Literacy
IF WE INCLUDE YOUR AGENCY IN OUR LISTINGS, YOU WILL BE ABLE TO LOG IN TO OUR WEBSITE TO DIRECTLY UPDATE YOUR PROFILE AND INFORMATION.	DESIRED LOGIN / USERNAME PASSWORD

		Hours: 9 a.m. to 5 p.m., Monday to Friday Center for Service in Action G301 Student Center Tel: (949) 824-3500 Fax: (949) 824-7971
Produced by the UCI Volunteer Center, A Division of Student Affairs Copyright © 2006 UC Regents Last Updated: 09/27/07