Online Joining

PARAGON2

Eastercon 2005
(56^th British National Science Fiction Convention)

25 - 28 March
Hanover International, Hinckley, Leicestershire, UK

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Paragon2 Online Registration

Please complete one form for each member. Please click tick box next to
each member you want processed.

If contact details are omitted for members 2-4 those for member 1 will be
used.

If child or infant members are to be included please put the responsible
adult in member 1 position.

Member 1

Forename Surname *

Badgename

Address1 *

Address2

Town/City *

State/county

Postcode

Country*

Email address

Telephone

* required fields

Membership type

Attending £40

Supporting £15

Junior £20

Child £5

Infant free

The categories of children are:

younger than 5: Infant
from 5 and 11 inclusive: Child
from 12 and 16 inclusive: Junior

Member 2

Forename Surname*

Badgename

Address1

Address2

Town/City

State/county

Postcode

Country

Email address

Telephone

* required fields

Membership type

Attending £40

Supporting £15

Junior £20

Child £5

Infant free

The categories of children are:

younger than 5: Infant
from 5 and 11 inclusive: Child
from 12 and 16 inclusive: Junior

Member 3

Forename Surname*

Badgename

Address1

Address2

Town/City

State/county

Postcode

Country

Email address

Telephone

* required fields

Membership type

Attending £40

Supporting £15

Junior £20

Child £5

Infant free

The categories of children are:

younger than 5: Infant
from 5 and 11 inclusive: Child
from 12 and 16 inclusive: Junior

Member 4

Forename Surname*

Badgename

Address1

Address2

Town/City

State/county

Postcode

Country

Email address

Telephone

* required fields

Membership type

Attending £40

Supporting £15

Junior £20

Child £5

Infant free

The categories of children are:

younger than 5: Infant
from 5 and 11 inclusive: Child
from 12 and 16 inclusive: Junior