Annual Dinner Registration Form Contact Information Company Name Company Contact Contact Email Guest Information Guest 1 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 2 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 3 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 4 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 5 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 6 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 7 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Guest 8 First & Last Name and email address (if available) If you wish to donate this seat, enter "N/A." Contact Information First and Last Name Organization (if applicable) Mailing Address Email address Phone Number Event Details Event Name Requested Event Date Event Start & End Times Requested Event Location 12-48 people 32-72 people 40-100 people Estimated Number of People Will this event require catering? No, I do not need catering Yes, follow up with me with recommendations Yes, but I do not need recommendations What is your food budget? What food preferences do you have? Appetizers? Dinner? Place your catering order (optional). Preferred Room Layout (see room configuration options above). 1. Theatre 2. Classroom 3. Conference 4. U-Shape Most popular Follow up with me with layout recommendations Will this event require any additional equipment? Check all that are applicable. Laptop and cords not provided Podium & Microphone Paper and markers not provided Markers not provided Preferred Payment Method Pay in person at the event Email me an invoice after the event Is your organization tax exempt? Yes No Additional Notes (optional) Name Child's Name Phone Number Address Child's Date of Birth Contact us Name Email Phone Number Message Latino Arts Strings Program Application Nombre del alumno/Student Name: Date/Fecha: Edad/Age: Grado Actual/Current Grade: Maestra de grado/Teacher Name: Nombre de Padre/Madre o Tutor (Name of parent or guardian): Dirección/Address: Teléfono celular/Home phone: Correo Electrónico/Email Address: ¿Por qué quiere que su hijo/hija participe en este programa?/Why do you want your child to participate in this program? Cual instrumento quiere tocar el alumno, violín, viola, cello o guitarra? / Which instrument is the student interested in playing, violin, viola, cello or guitar? Violin Viola Cello Guitar Other Contact Information Title Ms. Mrs. Mr. Dr. Mx. First Name Last Name Email Address Organization/School Information Organization Name Organization Phone number Principal First Name If you are a teacher, please provide your principal's contact information. Principal Last Name Principal Email Organization/School Address Street City State Zip Code Field Trip/Event Details Number of Participants Student Grade Range 1st-5th Grade 6th-8th Grade 9th-12th Grade College/University Not a school Group Total number of participants (including chaperones) Which performance, workshop, or event do you want to attend? Add an in-person gallery tour or lunch at Cafe El Sol to your experience! Lunch at Cafe El Sol In-person gallery tour Virtual gallery tour Virtual Loteria with Latino Arts Grupo Bella Matinee Concert 11/1 @ 10:30 a.m. Soy de aquí ahora Matinee Concert 12/6 @ 10:30 a.m. If you selected In-Person Gallery Tour, Please list dates and times you are interested in attending. *Please note the gallery is open Monday - Friday from 10:30am - 7:30pm First Name Last Name Title Phone Number Email Address Organization Information Organization Name Organization Phone Number Organization Address Street City State Zip Code Event Details Number of Participants Preferred Date / Time Which Loteria Experience Are you interested in? Live Loteria Package Standard Loteria Package Please upload your company logo. This will help us start drafting your custom Lotería card. Please share your company slogan, mission, or vision. List a few icons or words that would easily represent your company, industry, or company culture. Email Address First Name Last Name Company/Organization Mailing Address City, State, Zip Code Phone Number Contact Information Company Name Company Contact Company Email Guest Information For Table 1 Guest 1 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 2 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 3 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 4 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest Information for Table 2 Guest 1 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 2 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 3 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". Guest 4 First & Last Name and Email Address If you wish to donate this seat, enter "N/A". UCC Acosta Middle School LAS Nombre del alumno/Student Name: Date/Fecha Edad/Age: Grado Actual/Current Grade: Maestra de grado/Teacher Name: Nombre de Padre/Madre o Tutor (Name of parent or guardian): Dirección/Address: Teléfono celular/Home phone: Correo Electrónico/Email Address: ¿Por qué quiere que su hijo/hija participe en este programa?/Why do you want your child to participate in this program? Cual instrumento quiere tocar el alumno, violín o guitarra? / Which instrument is the student interested in playing, violin or guitar? Rate your virtual gallery experience! Excellent Good Okay Poor Let us know what your thoughts are! First and Last Name Title Group/Organization Name Address Address 2 City State Zip Code Phone Number Email Address Volunteer Project Information Approximate Number of Volunteers in your Group Age Range of Volunteers List the days of the week and timeframes your group is available. Please note we generally require at least four weeks notice to prepare for a group volunteer project. UCC's hours of operation are Monday–Friday, 9 a.m. to 5 p.m. Does your group require any special accommodations? My group is most interested in working with: (check all that apply) Elementary School students Middle School/High School students Adults Seniors My group can offer the following skills for the project (eg. craft-making, tutoring, singing, etc.) Is your group comfortable communicating in Spanish? Yes No If needed, can your group provide supplies for this project? Yes No United Community Center Community Services Health & Athletics Education & Enrichment Our Schools About Us Get Involved Contact us! Privacy Policy YVC Careers Partnerships Test Content Sitemap Form test page
