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| PRE-REGISTRATION and MEMBERSHIP FORM |
Click here for a printable form.
Print out form, fill it out and send it with your check or money order to:
Cinecon
3727 W. Magnolia Boulevard, # 760
Burbank, CA 91505
Pre-Registration Discount Offer Good Through Aug. 15 |
| Name: | _______________________________________________________________ |
| Address: | _______________________________________________________________ |
| _______________________________________________________________ |
| City: | ________________________________ | State: ________ | Zip: ___________ |
| Phone: | __________________________ | e-mail: | ____________________________ |
| | (optional)
| | (optional)
|
Pre-Registration Discount $150.00 each
(registration, membership, & celebrity banquet) | # _________ | $ ____________ |
| Or, order separately: |
| Full Registration $80.00 per person | # _________ | $ ____________ |
| Membership (required*) $20.00 each | # _________ | $ ____________ |
| Celebrity Banquet $85.00 each | # _________ | $ ____________ |
| TOTAL: | # _________ | $ ____________ |
Make Checks payable to: Cinecon |
| *Please note: Cinecon Membership
is Required for attendance |