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Arisia '04
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Arisia '04 Convention Registration Form
One Form Per Address
Registrations must be submitted by November 16 or December 15; See above:
( * = required field).
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Last (Family) Name
First Name (and middle initial)
Name on Badge (if different)
Enter any additional memberships below, discounts available for ten or more, please
inquire.
Last (Family) Name
First Name (& middle initial)
Name on Badge (if different)
Member type
*
Street Address Line 1
Street Address Line 2
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Town/City
State/Province
Postal/ZIP Code
Country
*
Email Address
This is my first Arisia.
Please do not put my name on your mailing list.
This is a new address since I last attended.
Please do not share my name with other SF organizations.
I am planning on hosting a party.
Where did you hear about Arisia?
Arisia is run entirely by volunteers, please consider helping out. Benefits include
a nifty staff t-shirt, access to food in the Den, crash-space for volunteers of limitied
financial means, plus free membership for next year's convention for people who work
twelve hours or more.
I would like to volunteer for
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Click link at right to start a secure transaction process by credit card. |
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