REGISTRATION FORM

Rousseau and the Visual

October 4-5, 2002

Registration Deadline: September 20
Fees: UC faculty & staff: $15; students with ID: no charge; others: $25.
Fees cover lunches and all refreshments.

Name _________________________________________________________________

Address _______________________________________________________________

Phone number __________________________________________________________

Check here if you do not have Internet access

Email address _______________________ UC status, UC department _____________

Number of persons ___________________ Total Enclosed ______________________

Send this form, along with your check (payable to UC Regents), to the

UCLA Center for 17^th- & 18^th-Century Studies
310 Royce Hall
Box 951404
Los Angeles, California 90095-1404

[Campus mail code: 140403]