Late Registration Form
Haiku North America 2009: Crosscurrents

 

If you are registering after June 30, 2009, please mail this completed form with your payment no later than July 27, 2009. Registrants will get a reduced-rate room code to the official conference hotel (the Crowne Plaza)—if this special offer is still available by the time we get your registration. Register as soon as you can!

 

Full Conference Rate

Full Conference August 5–9. Includes one conference anthology and the Saturday evening banquet with keynote speaker, John Brandi.

$245 US | $275 CDN

Daily Rates

Please indicate the days you want to attend

Wednesday August 5th

$45 US | $55 CDN

Thursday August 6th

$55 US | $65 CDN

Friday August 7th

$55 US | $65 CDN

Saturday August 8th (includes banquet)

$115 US | $140 CDN

Sunday August 9th (morning)

$45 US | $55 CDN

Merchandise

T-shirts  (Size: S  M  L  XL )

$20.00

Group photo

$10.00

Extra conference anthologies

$8.00

Donation to HNA 2009

Donations are optional, but much appreciated! All donations go directly to the local organizers.

 

 

Total Enclosed

 

 

Your Name(s):

 

Street Address:

State/Province:

 

Country:

 

Email:

 

 

Canadian Residents

 

Please mail this completed form with your payment in Canadian dollars by postal mail to:

 

Claudia Coutu Radmore

49 McArthur Avenue

Carleton Place, Ontario

Canada  K7C 2W1

 

Claudia’s email: claudiarosemary@yahoo.com

 

Please make checks to:
Haiku North America

U.S. and International Residents

 

Please mail this completed form with your payment in U.S. dollars by postal mail to:


Paul Miller

31 Seal Island Road

Bristol, Rhode Island 02809–5186

USA

 

Paul’s email:

pauldmiller@fctvplus.net

 

Please make checks to:
Haiku North America