California State University, Long Beach
Graduate Student Orientation Registration Form
Saturday, August 22, 2009

* * * PRE-REGISTRATION REQUIRED * * *

First Name _________________________ Last Name _________________________

Student ID Number __________________ E-mail: ____________________________

Street Address: ___________________________________________________________________

City________________________________________________ State _______ Zip _____________

Home Phone (______) __________________ Work Phone (______) __________________

Graduate Degree Program __________________________________________________________

Lunch will include a BBQ'd hamburger, fresh fruit, chips, cookie, and beverage.

I prefer a:

beef burger
veggie burger
turkey burger

I am interested in attending the following Optional Afternoon Workshop:

1:30-2:30 General Library Resources

Method of Payment

$25.00 -- Payment must be by check or money order made out to CSULB (received no later than Friday, August 14).

Mail this form and a check or money order to:

Attn:  Barbara Hall
Office of Academic Events
California State University, Long Beach
1250 Bellflower Blvd. (AS-124)

Long Beach, CA 90840-2006

For more information, please contact Barbara Hall at behall@csulb.edu or (562) 985-2351.