please print this form, fill it out, and mail to Eleusis with your payment:
REGISTRATION FORM:
EQUINOX GODDESS FESTIVAL
Name:
Address:
City: State: ZIP:
Phone: E-Mail address:
Prices: we encourage early registration!
A) Reception, Friday September 30, 2011::
-- $10 per person x number of people_________ = total :__________
The reception is in honor of Lady Olivia Robertson, co-founder of the Fellowship of Isis. It will be held at the Lyceum of Alexandria.
B) Gathering, Saturday October 1, 2011: :
$30 until September 15, 2011: Please do not mail anything after September 15!!
--Amount per person:__________ x number of people:_________________ = total:__________
C) Donation:
____I am unable to attend this years gathering, but I still want to make a donation
____I am attending, but I want to help with expenses: $ Your donation will REALLY help us a lot, and we are VERY grateful! Thank you!
D) Silent Auction:
Please check here if you have an item to donate to our silent auction:____________
Grand Total: $
No refunds will be given after 9/1/11
Please make checks or money orders payable to: DEENA BUTTA, and write FOI Gathering in memo line of check.
Mail payment and forms to:
Deena Hartray Butta, AU/SOI, Lyceum of Alexandria, 3334 W. Eastwood Ave., Chicago IL 60625
(773) 478-4763 deeankh@sbcglobal.net www.foichicago.org
