Vegetarian Summerfest
Registration and Accommodation Request Form
July 11-15   -   University Of Pittsburgh at Johnstown, PA
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Please print legibly. Mail completed form and payment in US currency
to: NAVS Box 72, Dolgeville, NY 13329 - for more info (518) 568-7970
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How did you hear about Vegetarian Summerfest 2001?
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Name________________________________________________________________
     Age(if youth or child)                    Circle Male or Female
Name________________________________________________________________
     Age(if youth or child)                    Circle Male or Female
Name________________________________________________________________
     Age(if youth or child)                    Circle Male or Female
Name________________________________________________________________
     Age(if youth or child)                    Circle Male or Female
For additional people, attach a separate sheet. 
Total number of people registering ____ .
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Address_________________________________________________________________
City__________________________ State___ Zip________ Phone_______________
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Please register me/us for the following (Please indicate your choice)
___ FULL CONFERENCE: July 11 - 15        ___ WEEKEND PACKAGE July 13 - 15
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ACCOMMODATIONS REQUESTED
___ Double room, NO air conditioning   ___ Double Room, air-conditioning
___ Single room, NO air conditioning   ___ Single room, air-conditioning
___ Ground Floor (Age / infirmity)
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___ I am registering on my own but I have arranged to share a room with
    Name________________________________________________________________
    Address_____________________________________________________________
    ____________________________________________________________________
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___ I am registering alone. Assign me a roommate so I can qualify for the
    double-occupancy room rate.
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PAYMENT INFORMATION
___ ADULTS               at   $__________ each       Total   $_________
___ YOUTHS  (12 - 17)    at   $__________ each       Total   $_________
___ CHILDREN (6 - 11)    at   $__________ each       Total   $_________
___ CHILDREN (2 - 5)     at   $__________ each       Total   $_________
DISCOUNT: Senior citizens - subtract $5, NAVS members - subtract $5 for 
individual/ $10 for family, Full-time adult student - subtract $40 full 
conference or$20 weekend package - copy of student ID must accompany 
registration form. Please circle which discounts you have taken.
                                                             $_________
                                                  Total Owed $_________
                                     Total Payment Enclosed  $_________
                      BALANCE (Due in full by June 11, 2001) $_________
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                          For credit card payments
(Visa/MC #): __________________________________________________________
Signature: __________________________________ Exp. Date _______________
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