| California Alliance
for Minority Participation 2007-2008 Registration Form |
| Personal
Information *(Required Fields) |
*First Name |
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*Last Name |
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*UCR ID# (860XXXXXX) |
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*UCR email address |
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Home phone (XXX-XXX-XXXX) |
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Cell phone (XXX-XXX-XXXX) |
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Academic Information |
*Major |
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*Class Level |
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*Ethnicity |
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*College |
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CAMP Participation |
*Years
participating in CAMP |
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*Participation in CAMP events |
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*Doing Research on Campus |
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*If answered yes on previous question, list the name of the PI, the department of the PI, followed by the length of time doing rsearch (ie. Dr. smith, Dept. of Computer Science, 2 quarters) |
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*Funded by CAMP (stipends, travel, programs, including refreshments at events)
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*If funded, please list accurately, yet succinctly, the name of each funded event and date if possible (Study Session, coffee break in October '05, Berkeley conference June 26, 06, Spring 04 stipend) |
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