REGISTRATION FORM
March 6, 2004
Registration Deadline: February
27
Fees: $5.00; students with ID: no charge
Fee is not refundable.
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 17th- & 18th-Century Studies
310 Royce Hall
Box 951404
Los Angeles, California 90095-1404
[Campus mail code: 140403]