Your Name:

Email:

Alternate Contact (phone, second email, etc.):

UID (Caltech only):

Affiliation:
Caltech Undergraduate
Caltech Graduate Student
Caltech Faculty
Caltech Alumnus
Caltech Staff
JPL Staff

Mailing Address:

Do you want a magnetic strip card? Only answer "Yes" if you do not have a Caltech ID, such as if you are a JPL Staff and possibly an alumnus. You will need this card to gain access to the shop. You will be charged $3.00, and if you are paying by check this should be added to whatever fees you are paying.
No
Yes

Comments: