╨╧рб▒с>■  +-■   *                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴3 °┐· bjbjdвdв "╚╚·      l░░░░░░░─rrrr ~─╧,Ю(╞╞╞╞╞0ЎNPPPPPP$√  rt░"╞╞""tZ░░╞╞ЙZZZ"j░╞░╞NZ"NZЇZN░░N╞Т р3СHз∙╔─оrМ^NNЯ0╧NН ъpН NZ──░░░░┘Registration deadline is September 21, 2009 Instruction begins on September 24, 2009 FALL 2009 REGISTRATION FORM If you are enrolling by mail, allow at least five days for receipt. Name___________________________________________________________ Address(Home(Business__________________________________________ City, State, Zip Code________________________________________________ Phone_________________________E-mail_____________________________ I am interested in the following course(s): 1. Department & Course #___________________________________________ Course Title____________________________________________________ 2. Department & Course#___________________________________________ Course Title____________________________________________________  FORMCHECKBOX  $150 for one course ($125 is a tax-deductible gift.)  FORMCHECKBOX  $250 for two courses ($200 is a tax-deductible gift.)  FORMCHECKBOX  This is a joint gift. Spouse/Partner name________________________ ( Credit Card ( Visa ( MC ( AmEx ( Discover Name on card:(please print)__________________________________________ Amount to be Charged Now $_________ Credit Card #_______________________________Exp. Date_______________ ( Check (Make check payable to The UCLA Foundation) Return this form to: Karen Rushfield UCLA Center on Aging - Senior Scholars Program 10945 Le Conte Avenue, Suite 3119 Los Angeles, CA 90095-6980 Phone: 310-794-0676 Fax: 310-794-0681 #6315 HS119 Vrs╖  !"_`nopоп╜╛┐ &'./ыь   3 Щ Э т Ў ∙ · ∙∙∙я∙я∙ф∙╓ф∙ф∙╚ф∙ф∙║ф∙я∙я∙я∙я∙я∙я∙░∙зЫСО░CJ5БCJOJQJ\Б5БCJOJQJ\Б^JCJOJQJ^J5БOJQJ\Б^JБjшOJQJU^JБjtOJQJU^JБjOJQJU^JjOJQJU^J jгЁOJQJ^J OJQJ^J-,UVrs╖╕°8~└ь4z─ Xз9еы E t ···°·ЎЇяяяяяяяяяяяяяяяяяЇх ДаД╨^Да`Д╨dh$a$· ■t Щ ╕ т Ў · ¤¤¤√¤ 1Рh░╨/ ░р=!░"░#Ра$Ра%░tD    eCheck1tD    eCheck2tD    eCheck3 i>@ё > NormalB*CJ_HmH phsH tH V@V Heading 3$$@&a$#5БB*CJOJQJ\Б^JaJph `@` Heading 7$ДАД╨@&^ДА`Д╨#5БB*CJOJQJ\Б^JaJph <A@Є б< Default Paragraph FontJP@ЄJ Body Text 2$a$B*OJQJ^JaJph ·    ,UVrs╖╕°8~└ь4z─ Xз9еыEtЩ╕тЎ№Ш0ААШ0ААШ0АА(0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААh0ААШ0АА· t · · !_oо╛·GХ GХ GХ   Check1Check2Check3`п№"p┐№LN╖╖╕╕"_pо┐(,:C№,T╖╖╕╕"_pо┐ №3%BNVZ╖╖╕╕"_pо┐∙№   krushfield)H:\senior scholars\Reg page email S09.docDepartment of Medicine*C:\agingsitemine\Reg page email fall09.doc @А4гt  ·P@  Unknown            GРЗz А Times New Roman5РАSymbol3&Р Зz А Arial?РАWingdings 25&Р Зz!А Tahoma"1ИЁ╨hЦЄ╓FЦЄ╓F▌э !Ёа┤┤ББ0 2ГQЁ  ]C:\Documents and Settings\krushfield.MEDICINE\Application Data\Microsoft\Templates\Normal.dot'Registration deadline is March 26, 2009 krushfieldDepartment of Medicine■ рЕЯЄ∙OhлС+'│┘0аРШ╚╘шЇ 4@ \ h tАИРШф(Registration deadline is March 26, 2009 krushfield Normal.dotDepartment of Medicine2Microsoft Word 9.0@xA╦@,╒Fз∙╔@,╒Fз∙╔▌э■ ╒═╒Ь.УЧ+,∙о0 hpДМФЬ дм┤╝ ─ °ф DoM UCLA  Ї" (Registration deadline is March 26, 2009 Title ■    ■   ■    !■   #$%&'()■   ¤   ,■   ■   ■                                                                                                                                                                                                                                                                                                                                       Root Entry         └F└№бHз∙╔.АData              1Table        WordDocument    "SummaryInformation(            DocumentSummaryInformation8        "CompObj    jObjectPool            └№бHз∙╔└№бHз∙╔■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           ■       └FMicrosoft Word Document MSWordDocWord.Document.8Ї9▓q