ALBACON 2005 Registration Form
Columbus Day Weekend
10/7/2005 – 10/9/2005

Membership Rates for 2005

(Circle Your Choice)			3/31/2005	9/15/2005	At The Door
Full Membership				$35		$40		$50
Gaming Membership				$15		$15		$20
Friday Membership				$25		$25		$25
Saturday Membership			$30		$30		$30
Sunday Membership				$25		$25		$25
Children's Membership*			$20		$25		$30
Kid In Tow Membership*			FREE		FREE		FREE
WorldCon Chairman* 			FREE		FREE		FREE
WorldCon Guests of Honor* 		FREE		FREE		FREE
SFWA Members 				FREE		FREE		FREE
Valid Non-North American Passport 	FREE		FREE		FREE
* For a Kid In Tow or Child Membership please provide their age.  For WorldCons, please provide the year.  No Mail Registrations after September 15, 2005! Canadian residents may pay for memberships using Canadian currency (cash only) at face value (on par) in person. Please do not send cash through the Postal Service (either Canadian or US).  Indicate on this form if you will be paying in Canadian currency at the convention.
*** Please Print Clearly ***
Mail with CHECK or MONEY ORDER to Albacon 2005, PO Box 2085, Albany NY 12220-0085.

Date:		______________
Name:		_____________________________________
Badge:		_____________________________________
Address:		_____________________________________
			_____________________________________
			City:	___________	State: 	____
			Zip+4:	_____ - ____	Country:	_________
			Postal Code:	_________________________
Phone:		_____________________________________
E-Mail:		_____________________________________
Website:		_____________________________________
Would you like to volunteer for the convention?			Y / N
Would you like information on Albacon sent to you via Email?	Y / N
How did you find out about Albacon?
	___ Another Convention		___ Publication (_______________)
	___ Previous Albacon		___ A Friend	___ Other
Age of Child or Kid In Tow (if applicable): 	<1  1  2  3  4  5  6  7  8  9  10  11  12
WorldCon Referenced (if applicable):		________