Registration Form
Please list additional Attendees – ALL ATTENDEES MUST BE REGISTERED
No charge for Children 16 or under when Accompanied by a Registered Adult
How did you find out about the Convention?
? Radio ? Web search ? Ham Club ? News Paper ? other ____________________
Call Sign: _________________ Last Name: __________________ First Name: _______________
Address: _________________________________ City __________________________
State: __________________ Zip Code: _________________ E-mail: _______________
Kids / Adults Call Sign Name (please print)
____ _____ _______ __________________________________________________
____ _____ _______ __________________________________________________
____ _____ _______ __________________________________________________

How many Early Birds For 1 $15.00 For 2 $30.00 For 3 $45.00 For 4 $60.00	Dated before May 31, 2010 $15.00 each
	Convention Pins Included (Limited Supplies)
How many Pre Registration For 1 $18.00 For 2 $36.00 For 3 $54.00 For 4 $72.00	Pre Registration June 1, to Aug. 22, 2010 $18.00
How many At Door For 1 $20.00 For 2 $40.00 For 3 $60.00 For 4 $80.00	At Door Registration $20.00 After Aug 22, 2010
	Accompanied kids under 16 years Free
How many At Banquet For 1 $43.00 For 2 $86.00 For 3 $129.00 For 4 $172.00 Plate Beef Chicken Vegetable 1 Beef & 1 Chicken 1 Chicken & 1 Veg 1 Veg & 1 Beef	Banquet Tickets Dinner ?Beef ? Chicken ? Vegetable $43.00
How many for Lunch For 1 $25.00 For 2 $50.00 For 3 $75.00 For 4 $100.00	Convention Lunch $25.00
Fill out form,Add Total amount  Please fill out form add paypal Confirm number and mail it to:

Early Bird @ _________ ea. = $___________
Convention Pins Included (Limited Supplies)
@ _________ ea. = $___________
At Door Registration $20.00 @ _________ ea. = $___________
Accompanied kids under 16 years Free
DX Breakfast $23.00 @ _________ ea. = $___________
Banquet Tickets Dinner ?Beef ? Chicken ? Vegetable $43.00 @ _________ ea. = $___________
Banquet Speaker: To Be Announced
Convention Lunch $25.00 @ _________ ea. = $___________
Lunch Speaker:
2010 Convention Pins $ 5.00 @ _________ ea. = $___________
2006 Convention Pins $ 3.00 @ _________ ea. = $___________
2002 Convention Pins $ 3.00 @ _________ ea. = $___________
QSL Card Checking
Make Checks payable to:
SANDARC Convention
C/O R. Boehme W2IRI
10340 Everell Pl.
Santee, CA 92071