Memorial Service for Myosen Olsen & Jack Williamson

Please Register or/and RSVP by filling out this form. E-mail us here if any trouble with registering online. Thank you!

Full Name *

Contact Info (Required) *

Please indicate your plan

Service only

Service & Reception Lunch

Do you need an accomodation?

Yes

No

Will you bring a guest(s)?

Yes

No

Total number attending for Reception (including yourself)

Make Donation via Paypal - Please select the amount ( Proceeds to go to Haku-un-ji) $25 $50 $100 $200 Other

Make Donation before or on the day of arrival

By Check

By Cash

Notes