Contact Name:
Phone Number:
E-mail:
Address Line 1:
Address Line 2:
Town/City:
State/Province:
ZIP Code:
Country:
I would like to receive information about future events at the Pok-O-MacCready Outdoor Education Center.
How did you hear about Pok-O and the event(s)?
Program(s)/Event(s):
Date(s):
Total # Attending:
Names and ages (if under 18) of those attending:
Total Cost:
Payment:
I will call (518) 963-7967 to provide my credit card information.
Please reach me at the number provided on this form for my credit card information.
I will mail a check to: PMOEC P.O. Box 397 Willsboro, NY 12996.
* Please note a 1% service charge applies to all credit card transactions.* To help keep your identity safe, the Pok-O-MacCready Outdoor Education Center prefers that you do not send your credit card information through an e-mail.
Please use the space below for additional comments and questions.
This form is powered by www.dbmasters.net.
Contact Us!ph: (518) 963-7967fax: (518) 963-4165PO Box 3971391 Reber RdWillsboro, NY 12996
E-mail Us!Would You Like More Information?Send Us Feedback!Teachers/ChaperonesStudents