Become an Advocate Version 2 - Government & Community Relations

Please fill out the questionnaire below so that we can learn more about your unique UCLA story, and how we might best work together to advocacy on behalf of UCLA.

While only the fields with an asterisk (*) are required, we appreciate your taking the time to fill out the entire form. You will also receive a complimentary UCLA Advocacy lapel pin for completing all sections.

*First Name

*Last Name

*Email Address

Telephone Number

*Address

*City

*State

*Zip

Social Media Handle (if applicable)

Campus Affiliation

Title

Campus Department

Degrees and Institutions

Years at UCLA

1. What higher education issues related to government support or legislation are you most passionate about?

2. If you conduct research, what is your area of study and how did you get interested in this field?

3. What is compelling about the impacts that your programs or research projects have on communities in California and outside of the state? (e.g. Impact on individuals, job creation)

4. How might your research have applicability to the military or national security?

5. What federal or state funding do you currently receive for your research or job that you do? (List agency and amount to the best of your ability)

6. Describe why it is important that government funds continue to support your research and the specific role that the government funding plays, as opposed to philanthropic or corporate funds. (e.g. Is it important that the research be seen as independent? Does it help leverage private sources of funding?)

7. I am interested in (check all that apply)

Writing letters

Writing emails

Making phone calls

Attending town hall meetings

Using social media

Participating in small group meetings with elected officials

Participating in small group meetings with agency staff

Attending an advocacy training

Attending a media training

8. Describe some key partnerships or memberships you have (non UC academic institutions, societies, associations, corporations/industry, non-profit)?

9. Ideas, comments or suggestions