SoCalMWA JUNE PROGRAM RESERVATION FORM

CHAMPAGNE BRUNCH

PANEL: THE GENTLE ART OF POISON
Douglas P. Lyle, M.D. and
Dr. David Ciambrone

 

Sunday, June 22, 2008
 
Sportsmen's Lodge
12883 Ventura Boulevard
Studio City, CA 91604
(818) 769-4700

MEMBERS: $30.00
GUESTS: $35.00

Make Checks Payable to: SoCal MWA
Remit to:

SoCal MWA
12021 Wilshire Blvd #506
Los Angeles CA 90025



Member Name _______________________________________________________________

Guest(s) ____________________________________________________________

Phone ___________________________ or E-mail __________________________



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