NRE Communication Form
For activities not awarding contact hours
Course Coordinator Name
*
First Name
Last Name
Course Coordinator E-mail
*
Title of Activity
*
Date of Activity
*
-
Month
-
Day
Year
Date Picker Icon
Activity Description
*
Purpose of Activity (Annual Skills Day, Procedural change, etc.)
*
Target Audience
*
Required NRE Assistance (Online registration, room reservations, technical/AV support, etc)
*
None
Yes (Complete the Logistical Support Form)
Submit
For assistance, contact Kathleen Feldman at
kfeldman@mednet.ucla.edu.
Revised 5/2016
Should be Empty: