REGISTRATION FORM

PPCA CONFERENCE

UNIVERSITY OF SOUTHERN CALIFORNIA

JULY 11-12, 2002

Institution

Address

City, State, Zip Code

Attendee #1 – Nametag

Attendee #2 – Nametag

Attendee #3 – Nametag

Attendee #4 – Nametag

Attendee #5 – Nametag

Attendee #6 – Nametag

Total enclosed at $39.95/ea.

Contact person:

Phone:

FAX:

E-mail:

Price: $39.95 each person

Make checks payable to:

University of Southern California

USC Tax ID: 95-1642394

Mail to: Vilma Perez, Administrative Assistant

University of Southern California

Facilities Management Services, MC# 0631

941 West 35^th Street

Los Angeles, CA 90089-0631

Phone: (213) 740-7844

Fax: (213) 740-5124

Email: vperez@busaff.usc.edu

Please return the registration form by June 28, 2002