Berkeley: University of California Extension, 1965. 8 1/2 x 11" application form, mimeographed from typescript on recto only.
Application form for the legendary conference, a watershed moment in the New American Poetry. The form lists readings and lectures by Jack Spicer, Gary Snyder, John Wieners, Leroi Jones (though he didn't eventually participate), Charles Olson, Koanne Kyger, Lew Welch et al. Perhaps, at the right post office, filling this out could get one there, but I don't know of the right po. Still, here's your form to get started.
Folded twice, with some additional creasing, small nick to upper margin, faint dampstain to upper margin. Very good. Item #29552