VSDC Thanksgiving 2009: Registration and Payment

Please follow the instructions as follows:

1. Fill out the form below

Today's Date:

Please provide first and last names of everyone that you will be paying for (you must do the math):

$51 for members and $54 for non-members Oct. 30 or earlier;
$54 for members and $57 for non-members Nov. 1 through Nov. 18;
$36 for children aged 3-12, and free for children under 3.

Name : Member?: Under 13?: Under 3?: Cost:

Guest 1: Member?: Under 13?: Under 3?: Cost:

Guest 2: Member?: Under 13?: Under 3?: Cost:

Guest 3: Member?: Under 13?: Under 3?: Cost:

Guest 4: Member?: Under 13?: Under 3?: Cost:

Guest 5: Member?: Under 13?: Under 3?: Cost:

Guest 6: Member?: Under 13?: Under 3?: Cost:

Guest 7: Member?: Under 13?: Under 3?: Cost:

Total Cost:

Request Confirmation of Payment and Reservations?:

If yes, what is your preferred method of confirmation?
E-mail Address:
Phone..............:

Table Requests: Under 40 Singles: Over 40 Singles: Couples: Families with Children:
Large Group (7 or more registering separately but would like to sit together. Please list names of all group members in comment field below or keep VSDC informed by e-mailing vsdcdatabase@yahoo.com as the group is finalized):
Other:

Special Needs: High Chair: Sign Language: Assistive Listening:

Comments:

3. Hit the REGISTER button below. An email should 'pop' up that you can then simply send. If you do not see an email, then mail your printed copy of this page to VSDC TG, PO Box 4921, Washington, DC 20008 OR, you can scan and email a copy of this page  to  vsdcdatabase@yahoo.com