Reservation Form
Edward K. C. Lee Dinner
Student Center, Pacific Ballroom D
Thursday, May 29, 2008

Name:
E-mail:
Phone:
Guest:
Guest:
Guest:
Guest:
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Total amount


Form of payment, please check one:
Account/fund
Check (Payable to UC Regents)

Comments:

(We apologize that we cannot accept cash or credit card payments. Tickets are non-refundable)

Please mail check to:
UCI Chemistry Department
Edward K. C. Lee Event
1102 Natural Sciences II
Irvine, CA 92697-2025