First * Last * Middle Name or Middle Initital Email Address * Personal Cell Number * Home Phone Number Street Address City State Zip Code UC Merced Graduate Program * - Select -Applied MathematicsBiological Engineering and Small-Scale TechnologiesCognitive and Information SciencesElectrical Engineering and Computer ScienceEnvironmental SystemsInterdisciplinary HumanitiesMechanical EngineeringPhysicsPolitical SciencePsychological SciencesSocial SciencesQuantitavie and Systems Biology - Select -Friday, March 6, 2015Saturday, March 7, 2015Both Days (March 6, 2015 & March 7, 2015)Please list date if visiting prior to Friday, February 28, 2014 Which day(s) will you be attending Graduate Visitation Weekend? Please list date if visiting prior to Friday, February 28, 2014 Flight Car Train Other (Please list below) Mode of transportation to Merced Other (Please list below) The Merced Courtyard Marriott has a group rate available for the Graduate Visitation Weekend participants from Thursday, March 5 to Saturday March 7. Would you be staying at the hotel or with a host? * Courtyard Marriott Hotel Faculty Host Student Host Overnight accomodations are not needed Number of night(s) staying? * - Select -12345 Anticipated Arrival Day * - Select -SundayMondayTuesdayWednesdayThursdayFridaySaturday Anticipated Arrival Time * - Select -1:00 AM2:00 AM3:00 AM4:00 AM5:00 AM6:00 AM7:00 AM8:00 AM9:00 AM10:00 AM11:00 AM12:00 PM1:00 PM2:00 PM3:00 PM4:00 PM5:00 PM6:00 PM7:00 PM8:00 PM9:00 PM10:00 PM11:00 PM12:00 AM Anticipated Departure Day * - Select -SundayMondayTuesdayWednesdayThursdayFridaySaturday Anticipated Departure Time * - Select -1:00 AM2:00 AM3:00 AM4:00 AM5:00 AM6:00 AM7:00 AM8:00 AM9:00 AM10:00 AM11:00 AM12:00 PM1:00 PM2:00 PM3:00 PM4:00 PM5:00 PM6:00 PM7:00 PM8:00 PM9:00 PM10:00 PM11:00 PM12:00 AM Mode of transportation to campus * - Select -UC Merced Hotel Shuttle (Roundtrip from Courtyard Marriott)Personal VehicleRentalBusCarpool Will you require parking on campus? * Yes No Please list any dietary or physical needs: Emergency Contact Person Name * Emergency Contact Person Phone Number * Emergency Contact Person Relationship CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
