New York Tri-State Network: Bruin First Thursdays

RSVP Information

Registration
Select	Description	Amount

Event Tickets

Sub-Total:
Tax-Deductible:

Give What you Can

I would like to make an additional donation to the UCLA New York Tri-State Alumni Scholarship.

If you cannot attend but would like to make a donation, please click here.

I would like to make a fully tax-deductible gift of * Other $ *

Grand Total:

Tax-Deductible:

Contact Information

Personal

Title:

First name:

Middle name:

Last name:

Suffix:

I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor

UCLA graduation year(s):

Contact Information

Street:

U.S. Addresses

City, State, Zip:

Non-U.S. Addresses

Non-U.S. City/County
or Province/Postal Code:

Country:

This address is my:

Home

Business

Home telephone:

Invalid phone number *

Business telephone:

Invalid phone number

E-mail address:

This e-mail is my:

Home

Business

Payment

If your transaction includes a payment, please select method.

Payment method:

Credit Card PayPal

Additional Information

	Job Title:
	Company Name:
	Do you or any of your guest(s) need ADA accommodations?:
UCLA Affiliation please check all that apply.
	Student:
	Alumni:
	Staff:
	Parent/Family Member:
	Community Member:
Guest Information The following fields are required for all of your additional guests. If you are the main registrant, no need to include yourself below as we have your information above.
Your First Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Second Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Third Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Fourth Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Fifth Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Sixth Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Seventh Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Eighth Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:
Your Ninth Guest:
	* First Name:
	* Last Name:
	Gender Pronoun:
	* UCLA Affiliation:
	* Email address:
	UCLA graduation year:

Comments:

New York Tri-State Network: NYC Bruins Fall Alumni Mixer

New York Tri-State Network:
NYC Bruins Fall Alumni Mixer