Please print this reservation form and mail or fax as shown below.
Name: ____________________________________Phone: ______________________ Additional Names: _____________________________________________________ Address: ______________________________________________________________ City, State, Zip: _____________________________________________________ $245(US) for first attendee, $195(US) second attendee, $150(US) each additional person; each attendee receives copy of Seminar Notes; first attendee receives copy of Family Butterfly Book by Rick Mikula; breakfast and lunch included with registration; hotel room not included ____ My Check is enclosed (payable to "Jack Mikula") ____ VISA ____ Master Card Card Number: ________-________-________-________ Exp Date: _______ (charges will appear on your statement as "Matrix Graphics Corp") Signature: ____________________________________________________________ E-Mail Address: _______________________________________________________ What are your interests in butterflies? (hobby, commercial, gardens, etc.) _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ FAX: (215)-340-7695 or mail to: The Butterfly Website 22 Charter Oak Court Doylestown, PA 18901
If you have any questions, feel free to call us at 215-340-7692 or email us at mgfx@mgfx.com