Application form for UW certificate program:
Intellectual Property Management 2008-2009 (Program ID# 2821)

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Return to program description

To apply, please print, complete and mail this form with your required materials to the address below.

The 2008-2009 program begins in September 2008. Applications are now being accepted and will be reviewed in the order they are received starting June 2 through August 22, 2008. After August 22, 2008 you are encouraged to call 206-685-8936 or e-mail us to learn if a program is still accepting applications.

I wish to apply to the UW Certificate Program in Intellectual Property Management. I enclose this completed form with a $50 nonrefundable certificate program fee and two stapled application sets, which include my résumé and letter of application.

Note: It is the applicant's responsibility to make sure that all required materials are submitted with the application. All applicants will be evaluated on the basis of materials submitted.

Mr.    Ms.
Last name:
First name/middle initial:
Social Security # (required):
Date of birth:
Mailing address:
City/State/Zip:
Daytime phone:
E-mail address:

Method of payment:

	Check in U.S. funds made payable to the University of Washington. (Returned checks are subject to a $25 service fee.)
	Third-party payer: separate document (purchase order or letter of authorization to bill) must accompany this application.
	VISA
	MasterCard

Card number:
Expiration date:
Name as it appears on card:
Credit card billing address:
City/State/ZIP
Signature:

How did you first hear about this program?
Ad    Adviser/Recruiter referral    Brochure    Catalog
Friend or colleague    Postcard    Newspaper article/calendar listing
Radio    Web site    E-mail    Other
Did you attend an information meeting? Yes No
Did you attend an open house? Yes No

In which professional associations do you have membership?