JohnCon 2003 Registration Form


Name: _____________________________________________

Badge Name: _______________________________________

...................................................

Additional Badge Names 
(if purchasing more than one badge):

 __________________________________________________	

 __________________________________________________	

...................................................

Address: __________________________________________

City: ___________________ State: _____ Zip: _______

E-mail Address: ___________________________________

Phone Number: _____________________________________

...................................................

Number of Badges Purchased: _____ 

Amount Enclosed: $ ______________


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    Registration Rates

$ 9 Pre-Registration Fee if you register 
    before February 14, 2003
$12 Registration Fee if you register 
    after February 14, 2003
$12 Registration Fee at-the-door
...................................................

Please print out additional forms if registering 
people who do not live at the same address.

Mail this form with payment to:

JohnCon '03
SAC Office, Mattin Center
Johns Hopkins University
3400 North Charles Street
Baltimore MD 21218