Registration Form

Name:___________________________________________________

Address:_________________________________________________

City, State, Zip:___________________________________________

Daytime Phone:___________________________________________

Email:___________________________________________________

Friday, March 2nd, Scandinavian Dinner and Wine, Nordic Heritage Museum, 6:30:	___ at $21	= ______
Saturday, March 3rd Conference at MOHAI (check-in begins at 8:30):
Early registration, must be postmarked Feb. 24th	___ at $30	= ______
Seniors (62+), students and presenters	___ at $20	= ______
Registration after Feb. 24th	___ at $40	= ______
Lunch may be ordered only with early registration; you may bring your own lunch, no food service nearby	___ at $12	= ______
Total enclosed		= ______
Check here if you plan on attending the Social Hour (no charge)		______

Mail to: PNW Historians Guild

4843 50th Avenue S.W.
Seattle, Washington 98116