Backspace Writers Conference - Registration Form

Registration Form

2008 Backspace Writers Conference
Registration Form

PLEASE TYPE OR PRINT CLEARLY - this is especially important for your email address, since all conference correspondence is by email.

PRINTING TIP: select one of the printing options using the icons at the top right

First Name

_______________________________________________________________

Last Name

_______________________________________________________________

Address

_______________________________________________________________

City

_______________________________________________________________

State/Prov.

___________________

Zip Code

___________

Country

___________

_________________________________________

___________

Email

Phone

Please check all that apply:

Backspace Member
Mystery Writers of America Member
Attendee

___________

___________ ___________

Conference fee:

_______ $355 (Backspace member)

_______ $395 (Non-member)

_______ $395 (MWA member - contact Margery Flax at: mwa (at) mysterywriters (dot) org to receive your $50 discount)

Total enclosed:

I have paid

_____________

_____________

(Check or money order made payable to Backspace, LLC)
(amount) via PayPal.

Note: Checks and money orders drawn on U.S. only, please. Registrants from other countries must pay using PayPal.

Send completed registration form,
along with appropriate payment to:

Backspace, LLC
P.O. Box 454
Washington, Michigan 48094

Vintage