UC Berkeley School of LawUCLA School of Law UC Davis School of Law UC Irvine School of Law UC Hastings School of the Law UCDC Law Program University of California Washington Center 1608
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UCLA School of Law
UC Davis School of Law
UC Irvine School of Law
UC Hastings School of the
Law
UCDC Law Program
University of California Washington Center
1608 Rhode Island Ave., N.W., Rm 342 Washington, D.C 20036
(202) 974-6392 (direct dial) (202) 974-6250 (fax) law@ucdc.edu
UCDC Law Program Travel Insurance Requirement Notification, Communications Plan and Placement
Information Confirmation Form
All students traveling outside the state of California for University-related purposes must sign up for free travel insurance coverage at https://www.ucop.edu/risk-services-travel/index.html Students are required to submit a copy of the insurance card to the UCDC Law Program and to their participating law school by e-mail or regular mail to the Law Program at the address above, and to one of the
following:
UC Berkeley School of Law UCLA Law School
sschechter@law.berkeley.edu MEAD@law.ucla.edu
Clinical Office Administrator Director of Externships Associate Clinical Professor
UC Davis Law School UC Irvine School of Law UC Hastings College of the Law
400 Mrak Hall Drive 401 East Peltason Drive 200 McAllister St.
Davis, CA 95616 dhughes@law.uci.edu geevargis@uchastings.edu
rgcontreras@ucdavis.edu
Name: _ Placement: _ Start Date: End Date:
Placement Information
Supervising Attorney: Precise office name: _ Address: Phone and e-mail:
Communications Plan
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Student address in D.C area:
E-mail: _ Placement phone:
Home phone: _
Mobile phone:
Emergency Contact Information
1) Name: _ Telephone: _ E-mail: Relationship: _ 2) Name: _ Telephone: _ E-mail: Relationship: _
Dates of Travel
Dates of travel from California to your placement: Dates of travel from your placement to California:
Dates during placement when you will not at your placement location: