Brandeis National Committee - San Fernando Valley Chapter



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__________________________________________________________________________________

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MAIL IN STUDY GROUP REQUEST FORM

PRINT, FILL IN PRINTING LEGIBLY, MAIL TO ADDRESS AT THE BOTTOM
USE ONE REQUEST FORM FOR EACH GROUP

Date___________________    

Group Title____________________________________________________Group Number____________

Meeting day and week _________________________________________Time______________________

Name_____________________________________________Home Telephone_____________________

Address________________________________________ City_______________________Zip_________

Email _____________________________________________________FAX ________________________

Comments and Suggestions: [Use other side]

Please return this STUDY GROUP REQUEST FORM TO THE FOLLOWING:
Book Groups: Ethel Kaplan  24116 Killion St.  Woodland Hills, CA 91367   818 346-6230
Movie Groups: Rosemary Rubin   5200 White Oak Ave #40   Encino 91346   818 783-1364
On the Town Groups & All Pending Groups: Evelyn Perl   4839 Rubio Ave   Encino 91436  818 905-5393
All other NUMBERED groups: Rosemary Rubin   5200 White Oak Ave #40   Encino 91346  818 783-1364
For all other questions - Evelyn Perl   eperl@mindspring.com   818 905-5393