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Name:
(As you would like it to appear on your name
tag)
_________________________________________________________
Date:_______________________
Address:____________________________________________________________________________________
City:
____________________________________
State:_____________ ZIP:
_______________________
Phone
(Day): ( _____ )______________________
(Evening): ( _____ )
_________________________
E-Mail
Address: _____________________________________
@ _____________________________________
(Check
One) [_] Paying by Check
(Make payable to CLASS)
[_] Please Charge my Credit
Card
Card
Type: _____________________ Card #
________________________________________________
Exp.
Date: _________________
Name
on Card:
_____________________________________________________________________________
Signature:
__________________________________________________________________________________
If
you prefer, credit card registrations may be
placed
by phone at (800) 433-6633
or by FAX at (505)
899-9282.
Amount
Enclosed
Full
Conference Registration
[_] $575 + $39.53 NM Gross Receipt Tax
= $614.53
To
assist us in planning and room set-up, please
indicate the
Comprehensive Class and workshop #'s you plan to
attend:
Comprehensive
Class:_____________________________________
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Workshops:
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Thursday
1:30 # _____
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Friday
1:30
# _____
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Saturday
1:30 # _____
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Thursday
3:00 # _____
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Friday
3:00 # _____
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Saturday
3:00 # _____
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Prologue Session #_____ Epilogue Session
#_____
Wednesday Footnote #_____ Thursday Footnote
#_____
Friday Footnote# _____ Saturday Footnote #
_____
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Editor/Agent
Appointments: Is there an editor or
agent with whom you want to meet? Editor
appointments will be announced on-site;
however, to assure you an appointment with
the editor or agent most important to you,
you may pre-request one appointment at the
time of your registration (based on
availability; early registrants are
practically guaranteed their first choice
-- in case your first choice's schedule is
already filled, please indicate a second
choice).
My
preferred editor/agent appointment
is:__________________________________
My
second choice
is:__________________________________
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Preferred
Time
(Please
only check
one):
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Thursday
AM____
|
Thursday
PM____
|
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Friday
AM____
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Friday
PM____
|
|
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Saturday
AM____
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Saturday
PM____
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Additional
appointments will be scheduled
on-site.
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Cancellation
Policy: Cancellations must be received in
writing 30 days in advance. Written cancellations
received before the 30 day deadline will be
promptly refunded, less a nontansferable $100
(+$39.53
New Mexico Gross Receipt
Tax).
Cancellations received after the 30 days will be
eligible for tansfer to another CLASSeminar but
will be subject to a $50 tansfer fee. Cancellations
received within 72 hours of the event are
nonrefundable nontransferable.
Please
print this registration form, then mail completed
form and check or money order to:
Glorieta Christian Writers Conference,
2201 San Pedro NE
Building 1 Suite 225
Albuquerque, NM 87110
or FAX credit-card registrations to (505)
899-9282
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