Name……………………………………………………………………………………

Address…………………………………………………………………………………

………………………………………………………………………………………….

Telephone…………………………………email……………………………………..

Number of nights: Friday ⁭ Saturday ⁭ (please tick for yes)

Total cost is £225 (includes Con registration, accommodation and all meals.)

Please email me if you need to pay by instalments. (rosemary.wild@virgin.net)

GB registrations: please send cheques in GB£. Make cheques payable to KER Wild and send to Mrs. R. Wild "Cwm Croesor", Stuckton, Fordingbridge, Hants. SP6 2HG (please do not use paypal unless you have no other method of payment + £2.00 charge)

European registrations: please use paypal and pay in GB£ (Plus £3.00 charges) or send euros cash at the exchange rate current at time of registration.

US and overseas registrations: please use paypal and pay in GB£. (Plus £3.00 charges) We regret we cannot accept $ cash.

Send paypal (www.paypal.com) payments to rosemary.wild@virgin.net

All registrations please print this form and send to Mrs. Rosemary Wild, "Cwm Croesor", Stuckton, Fordingbridge, Hants. SP6 2HG. U.K.

PROGRAMME PREFERENCES

My fandoms are: (in order of importance) …………………………………………………………………………………………………………

What would you like to see in the Con programme?

Would you like to help?

PERSONAL DETAILS (Please tick for yes)

I require a room with disabled facilities ⁭

I require vegetarian meals/ special diet (please specify) ⁭

Please place me in a bedroom next/near to

…………………………………………………………………………………………

Emergency telephone number while at the convention …………………………… Age statement (unless Village press has one on file). I certify I am over the age of 18 and understand the nature of the K/S premise. I understand I am responsible for all payments for this convention.