Lawrence Hall of Science
University of California, Berkeley
(as you would like it to appear on your name tag)
Partner's Name (if applicable)___________________________________________________________
City ________________________ State ______ Zip __________ Work Phone ( ____ ) _____________
Home address _________________________________________________________________________
City ________________________ State ______ Zip __________ Home Phone ( ____
Please check the appropriate workshop.
We encourage teams of people from the same community to take advantage of the discounted team rates. Team members must each fill out an application and return them together in the same envelope.
Visa or MasterCard accepted (please include: Cardholder's Name, Card Number, Expiration Date).
Make check/purchase order to: Regents of the University of California
Parent Partners Workshop: Wednesday, July 23, 2020
Parent Partners Workshop