OryCon 20 Membership Form



Please print out this form, fill it out, and mail it with your payment
to:

        OryCon 20
        PO Box 5703
        Portland, Oregon 97228

Mailed membership payments must be received by November 6.

List any additional names and addresses on the back or on a separate
sheet.

Name _____________________________________________________________

Address __________________________________________________________

City/State _______________________________________________________

ZIP/Postal Code __________________  Phone ________________________

Alternate Badge Name _____________________________________________

E-Mail Address ___________________________________________________

Please tell us where you found out about this Web page:

__________________________________________________________________


Would you like to work on OryCon 20?
        [] At the Convention   and/or [] On the Planning Committee

In the: [] Art Show    [] Hospitality  [] Other: _________________
	[] Operations  [] Registration

Please send information on: [] Art Show       [] Ad Rates 
                            [] Child Care     [] Fan Tables 
                            [] Special Events [] Other: __________

Other information requested/comments:

__________________________________________________________________


Return to the OryCon 20 Home Page