— Reservation Form —

Special Fundraising Event to Support the Clark Library Chamber Music Endowment Fund

St. Petersburg String Quartet
December 4, 2005

Reservation Deadline: November 21, 2005.
Admission: $75 per person, $60 of which is tax-deductible

Seating is limited. Checks will be returned if capacity is reached.
Tickets will be mailed or forms and checks returned by November 28, 2005.
Your application must be postmarked, or hand delivered no later than November 21, 2005.

Name __________________________________________________________________________________

Address ________________________________________________________________________________

_______________________________________________________________________________________

Phone Number ____________________

Number of persons _____

Amount enclosed ($75 per person) _____

Reservations will be confirmed, or forms and checks returned by mail on November 21 , 2005

Please enclose a check, payable to UCLA Foundation, and send it together with a copy of this form and a self-addressed stamped return envelope to the

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

[Campus mail code: 140403]

Inquiries:

310-206-8552
c1718cs@humnet.ucla.edu

To arrange for wheelchair access, please call the Center one week in advance. .