Author Mail-In Registration Form
Limited Space Available.
Click here for printer friendly PDF version.
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 Company, Inc., BOX 505, Wyandotte, OK 74370

Name: ___________________________________________________________________________

Address: _________________________________________________________________________

Phone Number:_______________________________ 

Email (for administration & PR): ________________________________  

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.
 

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

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

____ Friday Benefit Dinner  @ $30.00 each  = $_______________

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

____ Saturday Lunch Only  @ $15.00 each  = $_______________

Total Enclosed  = $______________