REGISTRATION FOR WEEKEND PROGRAM AT HUMBODT FRIENDS MEETING
NOVEMBER 4 - 5, 2000

Include payment ($30 - $50 per person, or less if you need a scholarship), payable to Quaker Center. Mail to:

PROGRAM DIRECTOR
QUAKER CENTER
P.O. BOX 686
BEN LOMOND, CA 95005

Name(s): ______________________________________________________________

Address: ______________________________________________________________

City and Zip: ___________________________________________________________

Phone: (____) ___________

E-mail: _________________________

Diet Restrictions/Other Special Needs:

_____________________________________________________________________

_______ I/We request overnight hospitality for

_______ I/We request childcare for ______ (number of children) aged ________ .

_______I/We request a scholarship deduction of $ ________.

_______I need a ride          _______I need a map

QUAKER BUSINESS PRACTICE HUMBOLDT RETREAT - REGISTRATION