CPO Alumni Sign Up Page

- Personal :
   
Salutation : *
First Name : *
Last Name : *
E-mail : *
Phone Number : * mobile home work
Alt. Number : * mobile home work
Fax Number : *
Date of Birth : * *
Address1 : *
Address 2 : *
State : *
City: *
Zip Code: *
   
- Education and Current Experience :
   
Degree : *
Year : *
Major(s) : *
Minor(s) : *
Graduate/Professional
School Degrees : 		*
Year : *
Institution : *
Job Title : *
Employer/Agency : *
Number of Years : *
   
- CPO Experience :
 
What project(s) were you a part of while at the CPO and which position(s) did you hold?
*
What skills you feel were important when you were a CPO student would be able to train current students in?
*
What type of work involved with and provide any resources to the community program office?
(e.g. training, funding etc.)
*
What other involvement at UCLA?
*
Please check off all the ways you would like to be involved:
Donate funds
Share information with students about funding
Share additional community contacts
Write letters of support
Update information on what alumni are doing now
Document alumni vision
Volunteer at an SIAC site
Mentor a CPO project director
Grant writing tips and/or connections
CPO Alumni directory
Participate in panels for trainings and classes
Conduct workshops sharing personal erperiences and how you have applied them in the community
Sit on the CPO Advisory Board
Collaborate on organizing campaigns
Other :
Other :
Other :
 
Is it okay to release your name, phone number and e-mail to an existing CPO student for contact?
Yes No
 
- _