Mail In Registration Form
Limited Space Available.
EXTENSION: If space is still available, reservations will be taken no later than September 29, 2010.
Click here for Pre-PayPal Form.

Mail for arrival before the above date to:
Gregath Co., Inc., BOX 505, Wyandotte, OK 74370

Name: ___________________________________________________________________________

Address: _________________________________________________________________________

Phone Number:_______________________________ 

Email: ________________________________  

Only 1 Genealogical/Historical OR Lineal Organization (for nametag): ________________________________________________________

Surnames researching (optional): _____________________________________________________________________________________________  


If registering more than one attendee for Benefit, Showcase, or Conference, please supply their name, nametag information, surnames and email (if applicable) for each. Nametag not supplied with Lunch Only.

Showcase Author Only:

Web address for web site and/or publisher (for PR): _______________________________________________________________________________________________________________

Only 1 Featured Title (for nametag & PR): ________________________________________________________

Additional Titles/Subject (optional but useful for promotion and cross-reference): _____________________________________________________________________________________________  


Please group me with other (circle one) Fiction OR Non-Fiction authors.
(circle one) All OR Most of my titles are thus.

(please check one)
o I will pick up my box lunch in the atrium.
o Please deliver my box lunch to my display.

____ Friday Benefit Dinner  @ $30.00 each  = $_______________

____ Saturday Showcase Full Table w/lunch  @ $25.00 each  = $_______________

____ Saturday Showcase Half Table w/lunch  @ $20.00 each  = $_______________

____ Saturday Genealogy Conference w/lunch  @ $25.00 each  = $_______________

____ Saturday Lunch Only  @ $15.00 each  = $_______________

Total Enclosed  = $______________
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