Fax completed form with credit card information to
510-643-0994 (a secure fax)
or
Mail completed form with check/credit card information to:

University of California at Berkeley
Lawrence Hall of Science
Berkeley, CA 94720-5200

The Search for Life in the Universe
Saturday April 11, 1998 8:30am-5:00pm

______Adult LHS members @ $17/person
______LHS members 10-18 years old @ $10/person
______Adult non-members @ $20/person
______Non-members 10-18 years old @ $12/person
______Lunch @ $8/person

Total enclosed: $___________

Tickets will be available at the door, space permitting,
for $25.00 per person. This workshop is not recommended
for children under 10 years old. Lunch is available only
with pre-registration.

Please print:

Name _______________________________________

Address ______________________________________

City ___________________________ Zip ____________

LHS Membership #: __________________ Exp: _________

Day phone: (______) __________________________

• Payment enclosed. Make checks payable to:
  The Regents of the University of California.
• Bill my Visa/Mastercard/Discover Card (circle one)
  Card #/Exp date:__________________________________

  CardHolder's name:________________________________

  Billing Adress: ___________________________________

  ______________________________________________

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