Here is my full payment of $_________ for [ ] Friday / [ ] Saturday at the 2010 Eisteddfod. (All rooms have private bath.)
adults, double; _____members @ $165 ea, _____non-members @ $172.50 ea=$________
____children (under 17, sharing with 2 adults), age_____, @ $40 ea= $________.
adults, triple, _____members @ $142.50 ea; _____non-members @ $150 ea=$________
adults, single, _____ members @ $215 ea; _____non-members @ $222.50 ea=$________
____Students (full-time) 17-22, in double room @ $130 ea = $_______
[ ] I wish to help support the Eisteddfod; my check includes an additional $_________. (Additional contributions are tax deductible, as permitted by law.)
Name___________________________________ Phone day (____ )________________;
Address__________________________________, eve (____)_____________________
City___________________________ State _____ ZIP ________________
E-Mail: ___________________________________
Emergency contact during weekend:________________________________
Other Names in Party:____________________________________________________________________
Requested room or roommate?_____________________________________
[ ] vegetarian; [ ] vegetarian eats fish; [ ] vegan; [ ] no red meat; [ ] no poultry; [ ] no fish; [ ] no dairy; [ ]other(explain:____________________________________________)
[ ] I will be driving from ____________________________________ at _____AM/PM and can take ___ additional passengers.
[ ] I need a ride, from ______________________________________________________, if possible
Do not include my [ ]e-mail and/or [ ]phone number on the address list..
*organizations include: Borderline Folk Music Club; Branford Folk Music Soc.; Country Dance and Song Soc. (CDSS); Folk Project, NJ; Folk Song Soc. of Greater Boston; Folklore Soc. of Greater Washington; New York Revels; & Peoples' Music Network. Please indicate which organization you are a member of.
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