Bruin Family Socials Participant Registration Form

UCLA Bruin Family Social Registration Form

Suggested Parking: Around the Historic Plaza & free lot behind the Cheese Factory

Hosted by Geeta Malik '89, Parent '29 and Cascade DuSel, Parent '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