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SOCIETY of CANADIAN CINE AMATEURS

for Amateur, Student, and Professional Film and Video Makers



IMM - 1999 SCCA CONVENTION REGISTRATION

Please Use One Form Per Person


GUEST INFORMATION  Please Print Clearly

First Name: ....................................................... Last Name: ....................................................................

Address  : ..............................................................................

City: …………..................................................... Prov./State: .....................

Ctry·:…........................................................…… Postal Code: .....................

Area Code # ….... Home # …….......…… Work # .................. Fax # :................. E-Mail .................................

REGISTRATION FEES
     Please read completely before filling in any blanks.

Attendance Sunday, August 8, 1999 - $20 Canadian X [1] person = $........
Attendance Monday, August 9, 1999 - $20 Canadian X [1] person = $........
                   OR
Attendance both days,               $30 Canadian X [1] person = $........
(if Returned with Fee before July 23rd)

Are you a Member in good standing of the SCCA?    Yes [  ]   No [  ]
Will you attend the Annual General Meeting?       Yes [  ]   No [  ]
(Lunch included for Members attending both days and the AGM & Registered by July 23rd)
               OPTION
Lunch at Art Museum, Sunday,August 8,$10 Canadian X [1] person = $.........

    The following two options are for our planning and need not be paid before arrival.
Do you plan to attend the IMAX Theatre, Saturday Evening, August 7th?  Yes [  ]   No [  ]
Do you plan to attend the Great West Steak House, Sunday, August 8th?  Yes [  ]   No [  ]

Please return this application form with payment to; -         CAROLYN BRIGGS
Payment accepted in Canadian funds only;                                       3 Wardrope Avenue South
Personal or company cheque (Canada only)                                      Stoney Creek, Ontario, L8G 1R9
International Money Order (outside of Canada)                                   Canada
(Please make cheques payable to SCCA)
If payment covers more than one application form, please staple payment to forms.

VISA ..... MC ..... # ................................  Exp ............ Name as it appears on Card ............................................

Signature ..............................................................