USIE 2026-2027 Application

Student Facilitator Application

We're excited that you're applying to facilitate a USIE Seminar!
A quick reminder of the key details:
- The final deadline for ALL application materials is Monday, March 30, 2026, at 5:00 PM PST.
- Your Faculty Mentor must submit their Faculty Mentor Agreement separately to the USIE Coordinator via email at usie@college.ucla.edu.
We look forward to reviewing your proposal!

NOTE: Applicants seeking to co-facilitate a seminar must consult with the USIE Coordinator before submitting their application.

FACULTY MENTOR INFORMATION
Name (First, Last)*
Department*
If your Faculty Mentor is with the Fielding School of Public Health, have you obtained department approval?

YesNo
Campus Phone
E-mail Address*
example@example.com

USIE SEMINAR INFORMATION
Title of Proposed USIE Seminar*
Provide a description of your proposed seminar*

0/450
Provide a tentative 10-week plan for your proposed seminar include discussion topics, assignments, and readings. *

Cancelof

STATEMENT OF PURPOSE
Share with the committee why you are interested in facilitating a USIE seminar. Please be sure to emphasize why this course would be a unique offering for the UCLA community. *

0/450

How did you hear about USIE?

Faculty memberCurrent or former UCLA studentEmail announcementSocial MediaApplication WorkshopUSIE Program websiteI have taken a USIE course previouslyCampus flyerOther
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Student Facilitator Application