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CEC-RB Lecture Registration
Print and fill out this form


Attendee Information:
Name(s)
                                                                         

 
Address

City, State, Zip

Phone (with area code)  
E-Mail Address


Lecture Information:
Lecture #
                                                                               
Title

Date

Fee
    Members -$5
    Nonmembers - $7


Instructions:
1.  Print this page with your web browser
2.  Enter your information and the lecture information you wish to attend
3.  Make your check payable to:  CEC/RB
4.  Mail to CEC/RB, PO Box 28099, San Diego, CA 92198-0099
     or bring to the lecture

For additional information, phone 858-487-0464