POP
2009 Registration Form
Parent/Attendee Name: _________________________________________
Parent/Attendee Name: _________________________________________
Parent Home Address: __________________________________________
City: __________________________
State : _______ Zip Code: _______
Parent Phone Number (Daytime):
_________________________
Email Address: ________________________________________
Daughter/Son Name: ___________________________________
Daughter/Son Student ID #:
____________________________
POP date(s) requested:
1st choice_______________________
2nd choice______________________
3rd Choice______________________
NOTE: Your space is guaranteed when you receive a confirmation letter.
The POP fee is $35.00 per parent/attendee (includes parking, lunch,
and resource materials).
Enclosed is $__________ for _________ (number of) attendees.
Mail this POP registration form (or the one attached to your letter
of invitation) with the appropriate fee (check or money order made
payable to "CSULB") to:
POP/University Center for Undergraduate Advising
California State University, Long Beach
1250 Bellflower Boulevard, HC-103
Long Beach, CA 90840-1009
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