Registration, Other Arrangements Order Number This form is only for those who have made other arrangements for registration. Please use the Register tab on the menu above if you have not been directed to use this specific form. First Name Last Name As you wish it to appear on your name tag Email Business Name or Tagline A slogan, genre, or phrase that appears under your name Phone City State - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Country (if outside the US) Provide the best number to reach you for questions regarding registration, transportation, or on-site issues. When will you arrive? When will you arrive? * Wednesday Thursday Friday Experience How long have you been editing? Aspiring editor Less than 2 years 2 to 5 years 6 to 15 years 16 years or more Dietary Needs (check if applicable) Vegetarian Gluten-Free Other (Explain in Comments below.) PENCON and Hotel Preston will do their best to accommodate your dietary needs. However, we cannot guarantee the selections. I can volunteer at the conference: Bookstore Speaker Assistant I'd like to join the planning team. Attendee Directory We are creating a directory for attendees to have everyone's contact information. We hope this encourages you to find out more about one another and network both at and after the conference. Each listing will include your name, email, website, phone number, and specialties (or a tagline). You may include all, some, or none of this information. Would you like to be included? * Yes, please include my name, email, and phone number as listed above. Yes, but please change my contact information as described in the Comments section below. No, please leave my name out of the directory. Website Specialties or Tagline Comments or Questions Arrangements * I received a FULL scholarship. I am on the planning team. Other
