1. Nomen et praenomen: ______________________________________

2. Inscriptiones

• cursualis publica: ______________________________________________

• electronica: __________________

3. Numerus telephonicus: ___________________________

4. Responsa brevia

• Quot annos linguam Latinam hactenus excoluisti? ____
• Docesne linguam Latinam? _____
  • Qua in schola/universitate doces? ____________________________
• Nonne carnes comedere soles? Vina bibere? ______
• Solesne fumum tabacinum haurire? _____

Quid faciendum
Hanc schedulam imprimendam exarandam mittendam cures una cum summa 250 dollariorum ad
SALVI c/o Nancy E. Llewellyn
UCLA Department of Classics
P.O. Box 951417
Los Angeles, CA 90095-1417

Notum sit quod participes dumtaxat 15 recipere possumus, nec ullam petitionem post Idus (15) Julias accipiemus.

Print out this application form and send it with your $250 deposit to the address above.
Application deadline: July 15, 2005, or as soon as all 15 places are filled!

Te nobiscum rusticaturum/am laetissimi exspectamus!