ConClave 32

Huckster Registration Form

 

Please print and mail this form to register for ConClave 31. You can print this form and fill it in by hand. (Please print clearly -- Neatness counts!) Or (hint, hint), you can type in your information here then print the completed form. Please mail this completed registration form to:

 

    Conclave, Inc.

    C/O Barber

    2737 Colony Road

    Ann Arbor, Michigan 48106

 

In either case, include your check or money order payable in U.S. funds to ConClave, Incorporated.

 

Please Provide your Name, Company Name, and Address:

 

Name (Last, First): ________________________________________________

 

Company Name: ______________________________________________________

 

Street Address: ____________________________________________________

 

City: _______________________________ State/Province:_______________

 

Country: ____________________________ ZIP/Postal Code:______________

 

Telephone: _________________________________________________________

 

E-mail Address: ____________________________________________________

 

Number of Tables: ______Special Needs(electricity, wall, etc.): ______

 

______________________________________________________________________

 

Your First Huckster Table includes one (1) Full Membership to ConClave 32.

You can also purchase additional Memberships at our special Pre-Registration Rates’

 

Yes! Please register us for the following additional ConClave 32 Memberships:

 

 ____ Membership(s) at $35 (Until October 1, 2007) = ___________;

   =============================================================

 

                     Total Additional Memberships = ___________

 

Please Provide Names for Each Additional Membership:

Name 2 (Last, First):

 

__________________________________________________

Name 3 (Last, First):

 

__________________________________________________

Name 4 (Last, First):

 

 __________________________________________________

 

For general ConClave Convention Information, please visit the ConClave 32 Home Page on the Internet at http://www.conclavesf.org