OFFICIAL LIBERTARIAN NATIONAL CONVENTION GUIDE
Official Registration Printable Form
     

 

  
  First person: 
First Name _______________________
Last Name_______________________
Address_________________________
Address ________________________
City____________________________
State ___________ Zip _____________
Badge Name _____________________
Phone ___________________________
E-Mail __________________________
Packages:
____Presidential $469
____Vice Presidential $389
____Senatorial $299
____Speaker $219
____Congressional $179
____Congressional Aide $178
____ Junior Congressman $99
____Vegetarian Meals Only
A La Carte Items:
____ Convention Book $35
____ Convention Bag $15
____ Opening Reception $25
____ Breakfast with Speaker $55
____ Luncheon with Speaker $55
____ Floor Speakers $35
____ Closing Banquet $125
A La Carte items sold with
Package purchase only.
Check enclosed: Check number ____ OR
Billing address:
Street: ____________________________
State: ________ zip _________________
Total paid:_______________________
  

Second person:
First Name _______________________
Last Name_______________________
Address_________________________
Address________________________
City____________________________
State ___________ Zip _____________
Badge Name _____________________
Phone ___________________________
E-Mail __________________________
Packages:
____Presidential $469
____Vice Presidential $389
____Senatorial $299
____Speaker $219
____Congressional $179
____Congressional Aide $178
____ Junior Congressman $99
____Vegetarian Meals Only
A La Carte Items:
____ Convention Book $35
____ Convention Bag $15
____ Opening Reception $25
____ Breakfast with Speaker $55
____ Luncheon with Speaker $55
____ Floor Speakers $35
____ Closing Banquet $125
A La Carte items sold with
Package purchase only.
Paying by Credit card: Visa or MC #
_________________________________
Apt: _____________________________
City: _____________________________
Signature __________________________

 
         
 

Mail Check to: Denver LPCon 2008
c/o Michele Poague
21079 E. Mineral DR.
Aurora, CO 80016

 

   Make check out to:
Denver LPCon 2008
Questions? Call 720.341.2193
Or 303.358.6047 		 
  Web site by http://www.zoemonroe.com   We are not the official web site of the Libertarian Party.