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September 19-21, 2003
Ann Arbor, MI

Mail to: Midwest Construction
c/o Midwest Fannish Conventions, Inc.
707 Sapling Lane
Deerfield, IL 60015-3969

Name:__________________________________________________________________

Address:_______________________________________________________________

City:__________________________________ State:_____ Zip:_______________

Country (if not USA):__________________________________________________

Phone:_________________________________________________________________

E-Mail address:________________________________________________________

Names of Additional Members:____________________________________________

______________________________________________________________________

______________________________________________________________________

Enclosed $__________ for ______ 3 Day Attending Membership(s) @ $35.00* each
(Good until 28-Feb-2003)
Enclosed $__________ for ______ 3 Day Attending Membership(s) @ $45.00* each
(Good from 1-Mar-2003 until further notice)
Enclosed $__________ for ______ Supporting Membership(s) @ $25.00** each

$__________ Total enclosed
Make checks payable to Midwest Construction 2

Midwest Construction is sponsored by the Midwest Fannish Conventions, Inc.

*Rate applicable through January 1, 2003
**Supporting memberships may be converted to attending memberships

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