Pleasures, Pursuits, and
Passions: Entertainment and Jane Austen
23rd Annual General Meeting Registration
Form
Jane Austen Society of North America
October 5-7, Seattle, Washington
Name:
_________________________________________________________________
(Please print your name as you'd like it on your I.D. Badge)
Mailing Address:
_________________________________________________________
(Number and Street)
City: _____________________State/Province: _______Zip or Postal code: ___________
Day Phone: _______________Evening Phone: _________________________
Email Address: _________________________________________________
Matched with roomate? (yes or no): _____If yes, Male or Female: __________
Arrival Date: _______Departure Date: ______ Booked a room? (yes or no): ___
Food choices (check one for each meal):
Banquet for Saturday:
Member's Choice:
Roasted Pork Tenderloin ____ Portabello Mushroom Ravioli _____
Companion's Choice: Roasted Pork Tenderloin
____ Portabello Mushroom Ravioli _____
Box Lunch for Saturday:
Turkey ______________ Vegetarian _______________
(If you don't make a selection, we will do so for you.)
| AGM Fee (postmarked before July 15) | $210 | $__________________ |
| AGM Fee (postmarked between July 15 and Sept 1) | $265 | $__________________ |
| Membership dues (for two years if not a member) | $57 | $__________________ |
| Box Lunch for Saturday | $14.50 | $__________________ |
| Additional Brunch/Banquet Companion Ticket | $70 | $__________________ |
| Sense and Sensibility Concert (October 5th) | $20 x _____ | $__________________ |
| Tax Deductible AGM Donation - Thank you | $__________________ | |
| Total | $__________________ |
Registration fees much be paid in U.S. dollars. Please make your check payable to "Jane Austen Society AGM, 2001"
Mail completed form and check to: Judith Fiedler, 1250 NW 126th Street, Seattle, Washington 98177
Refund policy: Full registration refunds, minus a $50 U.S. handling fee, will be given if written notification is received by 5:00 pm, September 1