Event Request Form

Thank you for your interest in inviting UC San Diego Chancellor Pradeep K. Khosla to your event.

To ensure that your request is received and considered, the online form below must be completed and submitted.

All event requests are reviewed, and the Chancellor’s staff attempts to fulfill as many requests as the Chancellor’s calendar allows. Depending on the topic or scheduling, you may be referred to another university official so that your request or need is addressed in a timely and respectful manner.

Submit this form six weeks prior to the event date. You will receive notification of the Chancellor’s availability once your request has been reviewed. Upon approval of this request, you will be sent event protocol details and a briefing document for you to complete and return.

For questions, please send an e-mail to .(JavaScript must be enabled to view this email address) or call (858) 534-3135.

This form is for internal campus use only. If you are a member of the general public, please call (858) 534-3135.

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Contact Information

Event Information

If there is flexibility, provide 2-3 options.

To select multiple audiences, hold down the “CTRL/command” button on your keyboard.

Chancellor’s Role

To select multiple roles, hold down the”CTRL/command” button on your keyboard.

If the Chancellor will be speaking, fill out the following fields: