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ΦΒΚ at Asilomar February 17-20, 2023
Deadline for Reservations: January 20, 2023

Registration fee: # Attending _______  Please pay the appropriate fee

  • A/ You are a currently paid member of PBKNCA or a new initiate who has joined PBKNCA – $125.00
  • B/ You were elected to PBK in college but have not joined PBKNCA or your dues have lapsed – $155.00
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

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)

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