region3.org - Summit Registration

region3.org -- Welcome to Headquarters, Region Three, STARFLEET

Last modified:
Tuesday, 16-Jun-2009 09:06:07 PDT

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Registration

Type	Cost	No. Needed
Regular Membership	$25.00
Youth (6-14) with adult paid membership	$10.00
Kids (0-5) with adult paid membership	Free

First Name
Last Name
Name on Badge
Additional Members format: Name (Badge Name) <Youth/Kid, if applicable> ex: Joe Snuffy (Goofball) <Youth>
Contact Phone
E-mail
Street Address
Address (Cont'd)
City
State
Zip Code
Would you like to be a volunteer?	Yes No
Would you like to be a Program Participant?	Yes No
I am interested in the following at FenCon:	Dealers' Room Filking Gaming Guests Panels Art Show Video Room Autographs Costuming
Other Interest
Suggestions / Interests / Hobbies (i.e. science fiction writers, tv shows, filk)
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Pay Pal Payment Option

Region Three has set up a Pay Pal Account to make it easier for you to pay for your Summit 2009 Registration. If you would like Region Three to bill you for your Summit 2009 registration via Pay Pal, please click on the appropriate box below. Not clicking on one of the following boxes indicates that you will be sending in your payment via the US Postal Service.

YES, bill me via Pay Pal
NO, do not bill me

For more information on Pay Pal go to www.paypal.com.

Registration Confirmation

You will be receiving a confirmation e-mail soon. Please print out this confirmation e-mail and bring it on the day of the event.

Make your check or money order payable to "Region Three" and mail it to the address included in your confirmation e-mail.