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Registration Form

Warren College Family Day
Saturday, February 9, 2008

To register, please print out this page, complete the form, and return it to us by mail. Confirmation of registration will be sent via email. Please return this completed form and payment before January 31, 2008.

Name (please include all attendees): _______________________________________________
    _______________________________________________
Address: ___________________________________________________________
  ___________________________________________________________
Phone: ___________________________________________________________
E-mail: ___________________________________________________________
UC San Diego Student Name: ___________________________________________________________
Class Level: ___________________________________________________________
Total # of adult attendees: ___________Total # of UC San Diego student/youth attendees: _______
Total amount enclosed: ____________

Registration Fee: $30.00 per Adult
$15.00 per UC San Diego Student/Young Attendees

(Includes lunch and morning refreshments)
Please make checks payable to UC Regents.

Mail registration form and payment by January 31, 2008 to:

University of California, San Diego
Earl Warren College
Attn: Family Day
9500 Gilman Drive # 0422
La Jolla, CA 92093-0422

Information: Call (858) 534-1709, e-mail waprovost@ucsd.edu, or fax (858) 534-7391

 



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