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REGISTRATION FORM

LAtino Poetry: Hispanic Poets in Los Angeles Who Write in English

March 6, 2004

Registration Deadline: February 27
Fees: $5.00; students with ID: no charge
Fee is not refundable.


Name _________________________________________________________________

Address _______________________________________________________________

Phone number __________________________________________________________

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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]




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