UCLA Extension

Reservation Form

Submitting your reservation form secures your space. Payment or PO must be received on, or before March, 12, 2021. Once we receive your reservation form, we will email you registration information.

See “Course Schedule” page for more information about each course.

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 your confirmation packet and class schedule after we receive your reservation form.

The 100th Technical Management Program – March 22-26, 2021

Reg#: 376235 Technical Management Program
Fee: $4,995 – see “Enrollment Information”

* = required.

    Name *  as it is to appear on my Award of Completion MrMrsMs
    		 MaleFemaleNB
    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  A1A4A5 Period 1  A1A4A5
    Period 2  B2B4B5 Period 2  B2B4B5
    Period 3  C1C3C4C5 Period 3  C1C3C4C5
    Period 4  D1D3D5D6 Period 4  D1D3D5D6

    Third Choice
    Please select 1 course number for each period.
    Period 1  A1A4A5
    Period 2  B2B4B5
    Period 3  C1C3C4C5
    Period 4  D1D3D5D6
    How did you hear about TMP?