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| ΦΒΚ at Asilomar February 17-20, 2023 |
| Deadline for Reservations: January 20, 2023 |
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Registration fee: # Attending _______ Please pay the appropriate fee
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| Check payable to PBKNCA. Enter “Asilomar” on check |
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Mail to: Barry Haskell, 1190 Fairbrook Dr., Mountain View, CA 94040 |
| Questions? Text or Call Ray Hendess at 707 364 7615 |
| Member Name(s): |
| Member PBK Alma Mater: |
| Member Address: |
| Member Phone #(s): |
| Member Email (essential!) |
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Vaccination, booster and mask required, If you did not attend last year, please send a photo of your and your guests Covid cards to PBKNCA@sonic.net Or mail a printed copy to Ray Hendess, 210 West St, Petaluma CA 94952 See our Policy for Attendee safety at PBKNCA events. I confirm I and any guests are or will be fully vaccinated, have boosters and will wear a mask Sign here_____________________________________ |
| Is this the first time you have attended our Asilomar Conference? |
| Where initiated to ΦBK (For your name tag) |
| Guest name(s) |