| Conference & Cost Information |
| Conference |
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| Meals
& Housing |
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Membership Discount
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| Personal Information |
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Your Full Name
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Email Address
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Daytime Phone Number
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| Evening Phone Number |
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| Address |
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| City/Town |
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State/Province
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| Postal/Zip Code |
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| Country |
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How'd you hear
about us? |
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| Payment Information |
| Deposit Amount |
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$100 or more, please include your membership and donation amounts.
Your balance will be due upon arrival. |
| Work-Exchange |
Please check here if you'd like to contact us about bartering. |
| Payment
Method |
Visa MasterCard Check
or money order
Please
call to get credit card number |
| Credit card number |
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| Expiration date (MM/YY) |
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| Name on card |
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| Other Information |
| Please check here if you need
a ride or can give a ride |
| Do you snore? Yes
or No |
| Please let us know about any special meal, health, or housing
wishes: |
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