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Costume
Con 28 Membership Form
NAME(S):___________________________________
___________________________________
___________________________________
___________________________________
ADDRESS:__________________________________
CITY:__________________STATE:____ZIP:_______
E-MAIL
ADDRESS(S):_________________________
___________________________________
PHONE
NUMBER:____________________________
MEMBERSHIP TYPE:
ATTENDING
___ COUPLE ___
YOUTH
10 to 18 ___ FAMILY ($ )____ OPTIONAL KID IN TOW BADGES_____($5 EACH)
Make
Checks Payable to: Costume-Con 28
Circle
1 (one) option below:
YES
I would like to receive mailings from future Costume-Cons
NO
I do not want to
receive mailings about future Costume-Cons
Circle
1 (one) option below:
YES
Please e-mail me the latest information about CC28!
NO
Don't e-mail me the latest information. The regular Progress Reports
will be sufficient.
Mail
completed from to
Costume-Con
28
P.O.
Box 1637
Milwaukee,
WI 53201
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