Pleasures, Pursuits, and Passions: Entertainment and Jane Austen
23rd Annual General Meeting Registration Form
Jane Austen Society of North America
October 5-7, Seattle, Washington

 

Name: _________________________________________________________________
                                      (Please print your name as you'd like it on your I.D. Badge)

Mailing Address: _________________________________________________________
                                                            (Number and Street)

City: _____________________State/Province: _______Zip or Postal code: ___________

Day Phone: _______________Evening Phone: _________________________

Email Address: _________________________________________________

Matched with roomate? (yes or no): _____If yes, Male or Female: __________

Arrival Date: _______Departure Date: ______ Booked a room? (yes or no): ___

Food choices (check one for each meal):

Banquet for Saturday:

    Member's Choice:        Roasted Pork Tenderloin ____  Portabello Mushroom Ravioli _____
    Companion's Choice:    Roasted Pork Tenderloin ____  Portabello Mushroom Ravioli _____

Box Lunch for Saturday:

     Turkey ______________  Vegetarian _______________

(If you don't make a selection, we will do so for you.)

AGM Fee (postmarked before July 15) $210 $__________________
AGM Fee (postmarked between July 15 and Sept 1) $265 $__________________
Membership dues (for two years if not a member) $57 $__________________
Box Lunch for Saturday $14.50 $__________________
Additional Brunch/Banquet Companion Ticket $70 $__________________
Sense and Sensibility Concert (October 5th) $20 x _____ $__________________
Tax Deductible AGM Donation - Thank you   $__________________
Total   $__________________

Registration fees much be paid in U.S. dollars.  Please make your check payable to "Jane Austen Society AGM, 2001"

Mail completed form and check to:  Judith Fiedler, 1250 NW 126th Street, Seattle, Washington 98177

Refund policy: Full registration refunds, minus a $50 U.S. handling fee, will be given if written notification is received by 5:00 pm, September 1