Print this page. On a Mac hit the Command + P keys on your keyboard at the same time, on a PC Control + P keys.
|
ΦΒΚ at Asilomar February 17-20, 2023 |
Deadline for Reservations: January 20, 2023 |
Registration fee: # Attending _______ Please pay the appropriate fee
|
Check payable to PBKNCA. Enter “Asilomar” on check |
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!) |
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) |