REGISTRATION FORM

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

Artemis Quartet

April 17, 2005– at the Clark Library

Reservation forms must be postmarked or hand-delivered to the Center no later than March 14, 2005.
Admission: $75 per person, $60 of which is tax-deductible
Seating is limited. Checks will be returned if capacity is reached. Reservations will be confirmed, or forms and checks returned, by mail no later than March 28, 2005.

Name _________________________________________________________________

Address________________________________________________________________

City. State, Zip Code_____________________________________________________

Phone number __________________________________________________________

Number of persons ___________________

Total Enclosed ($75 per person)______________________

 

Submit your completed form, along with your check (payable to The UCLA Foundation) and a stamped, self-addressed envelope, to the

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

[Campus mail code: 140403]


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