Jepson Herbarium 2012 Workshop Series Registration Form
This is a fillable form: you can type directly on to this form, or you can print
the form and fill it out by hand. Please mail your completed registration form
with payment to:
Jepson Herbarium Workshops
1001 VLSB #2465
Berkeley, CA 94720-2465
PLEASE NOTE:
For security reasons, we
cannot accept registration
forms by fax or e-mail.
Participant Information
Course prices are listed as Jepson Friend/General Public
Are you a Friend of the Jepson Herbarium?
Yes
No
To become a Friend, please see http://ucjeps.berkeley.edu/jeps/friends/index.
html
Please check the boxes to indicate your registration requests:
Basic Botany Series
Intro. to Plant Morphology $150/$175
Fifty Families (SF Bay Area) $200/$225
Intro. to California Plant Families $200/$225
Fifty Families (Carmel Valley) $460/$485
Name:
Weekend Workshop Series
Address:
City: State & Zip:
Preferred Phone:
Cell
Work
Home (please check one)
Alternate Phone:
Cell
Work
Home (please check one)
e-mail address:
Emergency contact information
Introduction to Bryophytes $235/260
Biogeography of Big Bear $475/$500
Wetland Restoration $360/$385
Carex $460/$485
Death Valley’s Endemic Flora $475/$500
Juncaceae $235/$260
Flora of San Luis Obispo County $475/$500
Potentilla $235/$260
Poaceae $235/$260
Atriplex and Tarweeds $235/$260
Lilies of the Field $235/$260
Late-season Flora of the White Mountains $495/$520
Seaweeds of Central California $460/$485
Fall Spectacular in the Siskiyous $475/$500
Dudleya $235/$260
Evolution and Diversity of Mushrooms $235/$260
Bees and Pollination Ecology $360/$385
Please make your check payable to UC Regents, or pay by Visa or Mastercard:
Name:
Relationship:
Phone number:
Please list any dietary restrictions or special needs we should be aware of:
Account Number:
Expiration Date:
Amount Enclosed:
Signature:
Billing address (if different from address at left):
I have read and understand the cancellation policy.
How did you find out about our program?