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DESERT ROSE BAHA’I INSTITUTE • 1950 W Wm Sears Dr • Eloy, AZ 85231

Ph: 520-466-7961    Fax: 520-466-7984     Email:  www.drbi.org

Session: Desert Rose Baha'i School, NOVEMBER 28-30, 2008

REGISTRATION DEADLINE: Monday, Nov. 14, 2008

Please print all information.

LAST name: _______________________ FIRST name: ____________________ M ___ F ___

Address: ____________________________________________________________________

City: _________________________ State: _____ Zip: _________

E-mail: _______________________________________ Phone _________________________

Last Name                                       First Name                                       M/F   Age if under 21

_______________________________ _______________________________ ____ _______

_______________________________ _______________________________ ____ _______

_______________________________ _______________________________ ____ _______

_______________________________ _______________________________ ____ _______

Special Meal Requirements? ___________________________________________________