M211 Mental Imagery signup

Sign up for Mental Imagery Seminar (M211A)

If you are planning to attend this course, please give us the following information:

The class will be limited to 15 students, and priority will be given to registered students in the neurosciences IDP

Items in RED are required.

First: and Last Name:

Your email

Are you in the Neurosciences IDP?:Yes No Attending for Credit Auditing Only

Your Department

Your Position

Your prefered Phone Number A/C ()

Your phone number will not be distributed. Please don't list my e-mail on the class web site

Anything else you would like to tell me now?

**Items in RED are required.**
First:	and Last Name:
Your email
Are you in the Neurosciences IDP?:Yes No	Attending for Credit Auditing Only
Your Department
Your Position
Your prefered Phone Number	A/C ()
Your phone number will not* be distributed*.	Please don't list my e-mail on the class web site
Anything else you would like to tell me now?

Please note that this is NOT a secure transmission.