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‘ Application for Registration
INSTRUCTORS’ DIPLOMA PROGRAM SUMMER 1975 - EE 2249

Name

‘Home Address

 

 

 

 

 

 

 

 

 

 

 

7 City
Work Address
City
Occupation Employer
Telephone (day) ___ (evening)
Subjects oie Grades/Levels taught
Course(s) in which you are enrolling:
1.D. 102 $85, 00):5 "si -u. a ores Pele et ets 4
1.D. 103 i $95.00 - $85. + $10 text and material fee) . a
I.D. 104 ($65.00 ~ $55 + $10 text fee) 96.6 sissies oie’) ())

TOTAL AMOUNT ENCLOSED...
Courses you have already completed:
HD. 1000) (51,0. 02( )  1.0.103( )  1.D. 104( )
Please make cheques payable to the University of British Columbia and mail with

this form to: REGISTRATIONS, Centre for Continuing Education, University of
British Columbia, Vancouver, B.C. V6T 1W5. Telephone 228-2181, local 220.