Experience The La Jolla Program.  A project of Center for Studies of the Person. 

August 2, 2008 5:00 p.m.
thru August 9, 2008 1:00 p.m.

REGISTRATION FORM:

Name:                                                                  

Mailing Address:                                                     

City:                      State:                    Zip:             

Phone:                              Cell:                              

E-mail:                              Fax:                              

Affiliation:                                                             

Charge my Credit Card $:           Visa           M/C        

Credit Card #:                                      Exp.            

Name as printed on card:                                         

Credit Card Billing Address:                                      

Signature:                                                              

Make checks payable to:  The La Jolla Program.

Amount Enclosed:$                     

Mail this form, along with check to:

The La Jolla Program, c/o Keddie Burrows, 354 S.E. Lee Lane, Bend, Oregon 97702.

For more information please contact:  Keddie Burrows:  justkeddie@yahoo.com or by cell phone:  541-480-4420.  You may also contact Bruce Meador:  bmeador@earthlink.net or by phone:  760-789-4794.