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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
|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 PBK Alma Mater:|
|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
|Is this the first time you have attended our Asilomar Conference?|
|Where initiated to ΦBK (For your name tag)|