Entertainment and General Event Information

To Be Announced

Name: ________________________________

Address: ______________________________

City:  _________________________________

State: _____ Zip: __________

Phone: ___________________________

E-mail: ___________________________

Others:

Name: _______________________age _____

Name: _______________________age _____

Name: _______________________age _____

Please mail this completed form to:

Desert Rose Bahá’í Institute:
1950 W. William Sears Dr.; Eloy, AZ 85131-1129
Or call 520-466-7961 (9 a—4 p MST weekdays),
or FAX to DRBI at 520-466-7984

PAYMENT BY:

_____ Check or Money Order (Made payable to DRBI)
_____ Visa _____ Master Card ______ Exp. Date

Card No. _________________________________________

Name as it appears on card: _________________________________________

Signature (of card holder)

_________________________________________