25th World Fantasy Convention Membership Registration

To purchase a World Fantasy Convention membership or banquet ticket, complete this form and mail it to: World Fantasy Convention, c/o MCFI, PO Box 1010, Framingham, MA 01701-1010.

Make checks payable to MCFI. Please don't mail cash. We also accept Visa and MasterCard. Credit card purchases may be faxed to +1-617-776-3243. Please don't email your credit card information. We do not have a secure server.

Name(s): _______________________________________________________________

Address: _______________________________________________________________



Country: ______________________ Phone number: __________________________

Email Address: _________________________________________________________

I am an: _____author     _____artist     _____editor      _____publisher
         _____agent      _____dealer     _____academic    _____collector

_____ I am interested in participating on the convention program. My
credits include:


(We regret that, due to the relatively small number of program items and
the large number of professionals in attendance, we cannot guarantee
everyone the opportunity to participate.)

The WFC banquet, at which the Awards will be presented, will be held Sunday
afternoon. Please indicate how many of each entrée you are ordering. The
cost of the Banquet is not included in membership.

____ Beef entrée ____ Salmon entrée ____ Chicken entrée

Banquet tickets are $42 each. Publishers (and others) desiring to purchase an
entire table (10 settings) should contact us directly, "Attn: Publiaison".

_____ I may be interested in having the convention provide babysitting
services. The child(ren) will be _____ years old as of November 1999.
(Hours, cost, and availability will be based on interest.)

  _____attending memberships @ $125.00   =  $_____ (through 15 October 1999)
  _____supporting memberships @ $35.00   =  $_____
  _____banquet tickets        @ $42.00   =  $_____
TOTAL                                       $_____

Payment by _____ Check _____ MasterCard _____ Visa

Credit Card # ________________________________________ Exp: ____________

Name on Card: __________________________________________________________

Signature: _____________________________________________________________

Mail your memberships to: World Fantasy Convention, c/o MCFI, PO Box 1010, Framingham, MA 01701-1010.

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