Bruin Family Socials Participant Registration Form

UCLA Bruin Family Social Registration Form

Hosted by Fati Adel '91, Parent '29 and Behnaz Naeim '89, Parent '26,'29

Name

First NameLast Name

Email

example@example.com

Phone Number

Format: (000) 000-0000.

10-digit UID (Optional)

UCLA Affiliation (Check all that apply)

Other

Student Name

First NameLast Name

Student Grad Year

(e.g. 2015)

Your UCLA Grad Year and Degree

(e.g. 1987; MBA '91)

Will you be bringing any guests to the Bruin Family Social?

Number of Additional Guests

Guest 1 Name

First NameLast Name

UCLA Alum?

Grad Year and Degree

Guest 2 Name

First NameLast Name

UCLA Alum?

Grad Year and Degree

Guest 3 Name

First NameLast Name

UCLA Alum?

Grad Year and Degree