Study Group Request Form - Online

Brandeis National Committee - San Fernando Valley Chapter

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STUDY GROUP REQUEST FORM - Online

PLEASE COMPLETE AND SUBMIT A SEPARATE REQUEST FORM FOR EACH STUDY GROUP
Remember - All spaces must be filled in!!   DON'T FORGET THE "SEND FORM" BUTTON AT THE BOTTOM.


Today's Date

Study Group Title

Study Group Number

Meeting Day and Week

Meeting Time

Your Name (last name first)

Preferred Telephone

Other Telephone

Address: Street

Address: City

Address: Zip code

Email address

repeat Email address (for accuracy)

Comments and suggestions


Please check the information above carefully for accuracy
 

For further information email Evelyn Perl at: eperl@mindspring.com



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