HAIKU NORTH AMERICA

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Click here to download a printable PDF version of the HNA 2017 LATE REGISTRATION FORM. Complete the form and mail it — one copy for each registrant — together with your check for payment to:

                                            Cynthia Henderson, HNA Registrar
                                            2705 Ventoso
                                            Santa Fe NM 87505
                                            USA


US dollar checks should be made out to “Haiku North America 2017.”
(This version is for online viewing only)
​

HNA 2017 LATE REGISTRATION FORM

All prices are in US dollars.
HOW TO REGISTER: Please complete this form — one copy for each registrant — and send it by postal mail or e-mail it to HNA as in the instructions. Payments by US dollar check made out to "Haiku North America 2017," or payments via PayPal are accepted.
 
FULL CONFERENCE, September 13–17, 2017. Includes all presentations, lunches Thursday–Saturday,
the Saturday dinner barbecue, and one copy each of the HNA 2017 anthology and group photo                                     $300
   —or--
DAILY ATTENDANCE.
Includes all presentations and lunch as indicated and one copy of the conference anthology.
Circle or check options desired. Please place a check mark by the days you plan to attend:
_____  Wednesday, September 13. Includes opening ceremony, reception, and evening activities                                   $40
_____  Thursday, September 14. Includes presentations, activities, and lunch                                                                  $90
_____  Friday, September 15. Includes presentations, activities, and lunch                                                                       $90
_____  Saturday, September 16. All presentations, activities, lunch, and evening reception & barbecue                        $180
_____        Presentations and lunch only (excludes evening reception & barbecue)                                                           $90
_____        Evening reception & barbecue only (excludes morning & afternoon presentations)                                        $90
_____  Sunday, September 17. Morning presentations and closing ceremonies; Tanka Sunday                                        free
 
OPTIONAL ITEMS
HNA 2017 T-shirts.  Indicate number of each size:  S ____ M ____ L ____ XL ____ XXL ____   @ $25                   _____
 
HNA conference anthology,
additional copies: please indicate the number of copies you want
in addition to the one free copy included with registration:                                                   ____   @ $10                     _____


DONATE to HNA 2017. All donations are greatly appreciated and are tax-deductible in the US.                                _____
 
                                                                                                                        TOTAL AMOUNT ENCLOSED: __________

                   Your Name       ________________________________________________________________
                   Street Address  ________________________________________________________________
                   City / State / Province / Country  _______________________ ZIP/Postal Code __________
                   E-mail  _______________________________________________________________________
                   Phone  ________________________________________________________________________

​NOTE: The attendee list provided in your registration packet will include your name and city/country
(not your full address). We'll also include your e-mail address unless you check “No” here.      _____

Click here to download a printable PDF version of the HNA 2017 REGISTRATION FORM to use if you're registering by postal mail.

​MENU FOR PAYMENT BY PayPal 

CONFERENCE REGISTRATION FEE
Options:
SOUVENIR T-SHIRTS
Size:
EXTRA COPY OF HNA ANTHOLOGY
DONATE TO HAIKU NORTH AMERICA
All donations are greatly appreciated and are tax-deductible in the US.
​Note: your donation will be treated as a separate transaction by PayPal.
​
GO TO >>   GENERAL INFO  |  REGISTRATION INFO  |  REGISTRATION FORM  |  HOTEL INFO  |  PROGRAM SCHEDULE
ARTS & CRAFTS  |  BOOK FAIR  |  SILENT AUCTION  |  CONFERENCE ANTHOLOGY  |  POST-CONFERENCE TOUR 
PRESENTERS' BIOS  |  
SPONSORS & DONORS  |  TANKA SUNDAY  |  BACK TO HNA HOME PAGE
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