subject_line
REC on the Go! | Programming Request
Client Information
First Name | Client
Last Name | Client
Email Address | Client
Phone Number | Client
Campus Affiliation
Student
Student working with college AS or GPSA
Staff
Faculty
Alumni
Community member | Non-affiliate
Organization | Department
Revelle
John Muir
Thurgood Marshall
Earl Warren
Eleanor Roosevelt
Sixth College
Seventh College
Eighth College
AS | Associated Students
GPSA | Grad & Professional Student Association
HDH | Housing Dining Hospitality
Other
Full Name | Client Supervisor
Email Address | Client Supervisor
Organization | Department | Other
Approved by Alfredo Barcenas | AS/GPSA
Yes
No
-
*DO NOT PROCEED*
Please contact
Alfredo Barcenas
| AS/GPSA for approval prior to submitting REC On The Go request