Registration Form

REGISTRATION FORM

Courts and Scientific Exchange in the Long Seventeenth Century

May 12-13 , 2006– at the Clark Library

Please note that Friday's
session will begin at 2:30 p.m.

Registration Deadline: May 5
Registration fees: UC faculty & staff: $15; students with ID: no charge*; others: $30.
Please be aware that space at the Clark is limited and that registration closes when capacity is reached. No confirmation will be sent, but we will contact you if we receive your registration after we reach capacity.
Fees are not refundable and apply to full or partial attendance.
Lunch and other refreshments are provided to all registrants.
Please call a week ahead to arrange for wheelchair access.

Name _________________________________________________________________

Address________________________________________________________________

City. State, Zip Code_____________________________________________________

Phone number __________________________________________________________

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]

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

View the program for Courts and Scientific Exchange in the Long Seventeenth Century
Return to the Calendar of Events

REGISTRATION FORM

Courts and Scientific Exchange in the Long Seventeenth Century

May 12-13 , 2006– at the Clark Library

Please note that Friday's session will begin at 2:30 p.m.

Name _________________________________________________________________

Address________________________________________________________________

City. State, Zip Code_____________________________________________________

Phone number __________________________________________________________

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 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

View the program for Courts and Scientific Exchange in the Long Seventeenth Century Return to the Calendar of Events

Please note that Friday's
session will begin at 2:30 p.m.

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]

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

View the program for Courts and Scientific Exchange in the Long Seventeenth Century
Return to the Calendar of Events