Glenn Seaborg Consortium Program Registration Form

"July Classic Film Series"

How many people will be attending? *    Adults: Children:

Your Name: *

Your Email Address: *

Your Telephone Number: *

Optional Message:

   

For programs with fees please send payment to:
Lafayette Library and Learning Center Foundation
3491 Mt. Diablo Blvd, Suite 214
Lafayette, CA 94549-3915

Or call (925) 283-6513 for Credit Card payments.

* These fields are required in order to confirm your registration.

Privacy Policy