Boskone 53 Registration Form — Must be received by January 16, 2016

____ Pre-registration at $50.00:
through 1/16/2016
$_____
____Students (K-12) at $25.00:$_____
____ Students (College) at $35.00:$_____

Total: $_____

Name: _____________________________________________________

Badge Name (if different): ____________________________________
(Please attach additional membership names and addresses on separate sheets. Thank you!)

Address: ___________________________________________________

City: ____________________ State: _____ Zip/Postal Code: _________ Country: _________________________

Phone: ___________________ Email Address: _____________________

School or College (if student): __________________________________

Please send me information about:

__ Joining NESFA __ Volunteering to help

Please make out check or money order (do not send cash thru the mail!) to Boskone. We also accept VISA, MasterCard, Discover, Amercian Express and PayPal (send to paypal@nesfa.org).

I am paying $______ by: __ check/money order __ credit card __ PayPal

Credit Card # ___________________________ Exp. Date: __________ CVV code: ________

Name on card: ________________________________________________________________

Signature: ____________________________________________________________________

Mail to: Boskone 53; PO Box 809; Framingham, MA 01701; U.S.A.
Fax to: 617-776-3243 (only credit cards on Fax orders)


Boskone is a registered service mark of the New England Science Fiction Association, Inc. This page is maintained by webmaster@nesfa.org