Innovation in Outreach Request for School Visit

Exit Survey
Questions marked with a * are required
100%
School Name
School Type
*If selected 'other' in previous question, please specify below:
Date of the Event:
(Please note: Campus tour dates in May are not available, as our calendar is fully booked during that month. Please select an alternative month when submitting your request.
For all other requests, our office will review your submission and connect with the appropriate point of contact for next steps.)
Type of Event
Total number of students
Number of students participating per grade level?
Number of Students
Headstart
Primary
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Other?
UTEP College and Career Readiness Day/Fair/Classroom Presentations/UTEP College Day
Setup Time
Start Time
End Time
Tabling Event location setting
Classroom Presentation, please select one:
Lunch/Snacks
Field Trips to UTEP

Download Release and Indemnification Forms below:
  1. General Photo Release
  2. Release and Indemnification Agreement (Minor)
  3. Release and Indemnification Agreement (Adults)
Field Trip: Arrival Time at UTEP
Field Trip: Departure Time from UTEP
Please specify program, if applicable. (i.e. Purple Star, AVID, NHS, ENHS, Student Council, etc.)
Are ADA accommodations needed?
Special Tour Requests (enter N/A if none):
Lunch
Number of adults/chaperones
Number of buses
Will buses be waiting or returning to pick up?
UTEP Virtual Presentations
Virtual Platform to be used:
Start Time
End Time
Audio/video test run check-in time
Parent Presentations
Event Name
Start time
End time
Number of Parents Participating
Topic?
Preferred Language
Virtual/In-person?
Point of Contact Name
Position/Title
Phone Number
Email Address
School Phone Number
Questions? Please contact:
Andrea Dominguez
Director of Educational Outreach
Innovation in Outreach
Office of AVP for Outreach and Student Access
Division of Enrollment Management
Office: 915-747-5960
Email: aidominguez@utep.edu
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