REGISTRATION FORM
NAME: ________________________________CALL SIGN: __________
NAME: ________________________________CALL SIGN: __________
NAME: ________________________________CALL SIGN: __________
NAME: ________________________________CALL SIGN: __________
Mailing Address: ______________________________________________
City: ____________________________State: _____Zip: ____________
Phone: _______ - _______ - _______________ (include area code)
Email: (for registration conformation)_________________________________
Pre-Registration (before May 13) _________X $7.00 = $____________________
Post Registration (after May 13) _________X$10.00 = $____________________
Grand Prize tickets __________X $1.00 or 6 for $5.00 = $ _______________
Saturday Banquet __________X$17.00 per person = $___________________
Swap Table __________X$5.00 per table = $_____________________
TOTAL $_______________________
Make Check or Money Order to: Sweetwater Amateur Radio Club
Remit to: Dave Gregory
1000 South Dakota
Green River, WY 82935