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Multiple School Approval For Student Participation in Off-Site Educational Activities


I. Contact information:

Name of lead organization: (no acronyms, please)

RCO contact person:

Campus e-mail:

Phone:

- -

II. Event information:

Event name:

Event date:

Day of week:

Sponsoring entity:

Event street location:

Event city location:

Detailed event description:

III. Other students, departments and groups participating:


Students from the following schools will participate (check all that apply):

Medicine
Dental
Pharmacy
Graduate Division
Nursing
Physical Therapy


List any other RCOs participating in this event:

List any other UCSF departments participating in this event:

List any non-UC entities participating in this event: