2011 - Continuing Education - Brigham Young University
2011 - Continuing Education - Brigham Young University
2011 - Continuing Education - Brigham Young University
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<strong>2011</strong> CAMPUS EDUCATION WEEK EARLY REGISTRATION FORM<br />
For optimum accuracy, please print capital letters in black ink and avoid writing on the lines. Submit one completed form for each individual.<br />
Students must be 14 or older. Registration by mail is due by Friday, August 5, <strong>2011</strong>; the in-person early registration deadline is Friday,<br />
August 12, <strong>2011</strong>, at 5:00 p.m. Please do not staple or tape checks/money orders to registration form. Duplicate this form as needed.<br />
Last Name<br />
Program registration is also available by telephone, 801-422-8925 or toll-free at 877-221-6716, and by Internet at http://educationweek.byu.edu.<br />
First Name Middle Name<br />
Mailing Address (include apartment<br />
number if applicable)<br />
City (include province for foreign address) U.S. State Zip Code<br />
Country if not U.S. Foreign<br />
Postal Code<br />
( )<br />
Daytime Telephone<br />
E-mail Address<br />
(This form is for early program registration through August 12, not for campus housing.)<br />
Using black ink, darken only one circle.<br />
Signature Cards may be purchased by telephone or Internet<br />
only through July 22. (See page 55.)<br />
-<br />
EARLY REGISTRATION TUITION THROUGH AUGUST 12:<br />
$64 Monday–Friday Full Day<br />
$54 Tuesday–Friday Full Day<br />
$61 Senior Citizen Monday–Friday Full Day (62 and over)<br />
$51 Senior Citizen Tuesday–Friday Full Day (62 and over)<br />
Make checks payable to Campus <strong>Education</strong> Week.<br />
Total check amount enclosed for this registration:<br />
$<br />
.<br />
Total<br />
Payment must be made in U.S. funds drawn on a U.S. bank.<br />
Canadian postal money orders in U.S. funds are also accepted.<br />
33<br />
Male<br />
Female<br />
/ /<br />
Birth Date (MM/DD/YY)<br />
$24 Tuesday–Friday Mornings Only (8:30 a.m.–12:05 p.m.)<br />
$24 Tuesday–Friday Afternoons Only (12:30–4:05 p.m.)<br />
$24 Tuesday–Friday Evenings Only (4:30–9:25 p.m.)<br />
$16 Monday Only Full Day (8:30 a.m.–4:05 p.m.)<br />
AGAIN in <strong>2011</strong><br />
$29 Tuesday–Friday Marriott Center Only (8:30 a.m.–4:05 p.m.)<br />
Bank card payments are not accepted<br />
with mail-in registrations. Bank cards<br />
may be used for telephone and Internet<br />
registrations through August 12.<br />
Mail to: Campus <strong>Education</strong> Week Registration, 120 Harman <strong>Continuing</strong> <strong>Education</strong> Building—BYU, PO Box 21531, Provo, UT 84602-1531<br />
EARLY REGISTRATION ONLY—PLEASE RETURN FULL PAGE WITH PAYMENT