2007 Search for Serenity Retreat

October 12 – 14, 2007

Registration Form

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Please complete and return this form with your payment to our address below. If you wish to pay by credit card, you may do so by following the instructions below the registration information.
Registration Information
Name:  
Address:  
 
City:  
State, Zip:  
Home phone:  
work or other phone:  
e-mail:  
Please provide at least a phone number or e-mail address
Please choose accommodation type
Private bungalow $325 ____
Two-man bungalow $240 per person ____
Three-man room $175 per person ____
Four-man room $100 per person ____
Contribution to help those who cannot afford the cost: $_______
Total amount enclosed: $_______

If you wish to share a room with specific rommates, please submit all your applications together, and note that they're for the same room.

Make checks payable to Friends of Choices, and mail to:

Friends of Choices
3825 Dunn Drive
Culver City, CA 90232

If you'd like to register and pay by credit card, you may fax this form
with the additional information below to (310) 915-1973

Please circle one:     Visa    Master Card    American Express
Total amount to charge, from above: $  
Card number:  
Expiration date (month/year):  
Name as it appears on card?  
Credit card billing address:  
 

(Credit card transactions will be processed by Baytronics South, Los Angeles, CA.)

For additional information or questions, please call Fran LaMountain at (310) 558-8383, or retreat chairman Mike C. at (310) 936-1188.