| A-Kon 20 Pre-Reg Form | |
| SEND ME | ___________ A-Kon ® 20 Memberships at $30.00 each. (make checks payable to "Phoenix Entertainment/A-Kon 19") |
| Also send me | ___________ A-Kon® 20 Banquet Tickets at $29.00 |
| And I want | __________ T-shirts at $18 ea. Size: _______ (M, L, XL, 2XL, 3XL are available and will be supplied with your pre-reg pack)
Shirt Color ___ White ____ Black (if ordering multiple shirts for people, tell us who gets what size!) |
| FULL NAME | _________________________________________________________________
If you are buying more than one membership, please give us full names of ALL persons attending. Use extra paper if necessary (or use additional forms) and please PRINT or TYPE CLEARLY). Multiple membership orders WITHOUT names for everyone cannot be process REAL NAME: _______________________________________________________ |