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Date___________________ Group Title____________________________________________________Group Number____________ Meeting day and week _________________________________________Time______________________ Name_____________________________________________Home Telephone_____________________ Address________________________________________ City_______________________Zip_________ Email _____________________________________________________FAX ________________________ Comments and Suggestions: [Use other side if necessary] 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, CA 91346 818-783-1364 On the Town Groups: Sharon Heller 6000 Fenwood Ave. Woodland Hills, CA 91367 818-884-3368 All other numbered groups: Rosemary Rubin 5200 White Oak Ave #40 Encino, CA 91346 818-783-1364 All Pending Groups: Evelyn Perl 4839 Rubio Ave Encino, CA 91436 818-905-5393 For further questions or information: - Evelyn Perl eperl@mindspring.com 818-905-5393 |