UCLA Extension

Reservation Form

Submitting your reservation form secures your space. Payment or PO must be received on, or before February 25, 2019 to receive the Early Bird 10% discount. Once we receive your reservation form, we will email you registration information. Payment is due by March 22, 2019.

Reserve early to get your top pick of courses! If your first choice is not available, you’ll be placed in your 2nd/3rd available choice. We will email you your confirmation packet and class schedule after we receive your reservation form.

The 97th Technical Management Program – March 24-29, 2019

Reg#: 365696 Technical Management Program 815
Fee: $4695 ~ see “Enrollment Information
Early enrollment fee: $4225.50 through February 25, 2019

* = required.
Name *  as it is to appear on my certificate MrMrsMs
MaleFemale
Job Title
Company *
Company Address
City
State
Zip
Daytime Telephone *
Your Email *
Home Address
City
State
Zip
Home Telephone
 

First Choice *
Please select 1 course number for each period.
Second Choice
Please select 1 course number for each period.
Period 1  A1A2A3A4A5 Period 1  A1A2A3A4A5
Period 2  B1B2B3B4B5B6 Period 2  B1B2B3B4B5B6
Period 3  C1C2C3C4C5C6 Period 3  C1C2C3C4C5C6
Period 4  D1D2D3D4D5D6 Period 4  D1D2D3D4D5D6

Third Choice
Please select 1 course number for each period.
Period 1  A1A2A3A4A5
Period 2  B1B2B3B4B5B6
Period 3  C1C2C3C4C5C6
Period 4  D1D2D3D4D5D6
How did you hear about TMP?