11th Annual GeoExpo: Registration and Dinner Preferences

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Thank you for registering and paying for the 11th Annual GeoExpo. Please fill out this form with your name tag information and dinner preferences. If your company is sending multiple guests, please have each attendee fill out this form.

Early bird event registration is $100 until May 25th. After May 25th, event registration increases to $125.

Please make checks payable to:
UC Regents

Memo to:
CalGeo at UCLA

Send Form and Checks to:
UCLA Department of Civil and Environmental Engineering
CalGeo at UCLA
5731 Boelter Hall, P.O. Box 951953
Los Angeles, CA 90095-1593

Thank you!

First Name *

Last Name *

Email Address *

Company/School Name *

Which of the following best describes you? *

Industry

Academia

Which entree would you like for dinner? *

Chicken Marsala: Pan-fried chicken breast with sauteed forest mushrooms and Marsala wine sauce.

Short Ribs: Boneless braised short ribs in red wine reduction.

Wild Mushroom Risotto (Vegetarian): Slow-cooked arborio rice with wild mushrooms and shaved Parmesan. ( Please note if Vegan or Gluten-free below).

Have you paid for registration yet? *

Early bird event registration is $100 until May 25th. After May 25th, event registration increases to $125. See form description above for instructions on where to send your checks.

Yes, I have already sent in my check.

Yes, my company is a sponsor.

No, but I will send in my check right away.

Please list any other dietary restrictions:

Do you have any additional comments or questions?

Submit

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