Marty Martini's Magic PO Box 189 Delta, PA 17314 Call us at: 717 - 456 - 6604 Fax to: 717 - 456 - 5692 Email us at: Marty@MartinisMagic.com Information Request Form Please fill out the following form to receive more information and we will contact you about registration... Organization: First Name: Last Name: Street Address: City: State: Zip: Phone:  Fax:  Email Address: Best time to call (Date and Time): Do you have any other questions or comments?

Martini's Magic, P.O. Box 189, Delta, Pennsylvania 17314 Phone: 717-456-6604 Fax: 717-456-5692 By e-mail: Marty@MartinisMagic.com