Inventory Data Collection Tool | Office of Outreach and Engagement

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First Name

Last Name

Email(Required)

School or College(Required)

UConn Campus Affiliation(Required)

Category(Required)

Please enter keywords that describe your program(Required)

Please use commas “,” to separate each keyword

Demographics

If known, number of people reached

Scope(Required)

If in Connecticut, Towns impacted (Please indicate all towns)

States(Required)

For international, indicate country or region. You may skip the question if not applicable