Enrollment Application

July 24 - 27, 2013

Download the application — Physics Review Course - Enrollment Application (PDF) — or print this page.

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Last Name, First Name, Middle Initial

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Address

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City, State, ZIP

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Day Phone, FAX

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Institution/Employer

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E-mail Address


FEE: $ 975 (U.S. dollars). Application must be postmarked by July 1, 2013.  Fee will be $ 1075 after July 1, 2013. 

Print out and complete the form and mail it along with a check, money order, or cashier's check payable to UC Regents to:

Lorraine Smith
UC Davis Medical Center
4800 2nd Avenue, FSSB-Suite 2500
Sacramento, CA 95817

Accomodations close to the course site:  The Courtyard by Marriott Sacramento Midtown is located at 4422 Y Street, Sacramento, CA 95817 (916) 455-6800.

E-mail your questions to Lorraine Smith, Course Coordinator, at losmith@ucdavis.edu.