Please fill out the form below to sign up for A Writer of Excellence Conference!

First Name	Last Name
Address
City	State   Zip
Phone	E-mail

Name as you wish it to appear on your badge

 

 

Conference Fees:

          Early Bird:  August 1 - August 31, 2005.........................$300

       Regular Fee:  September 1 - September 30, 2005...........$350

       Late Fee:  October 1 - October 22, 2005........................$400

(No refunds after September 15, 2005.  Refunds before September 15 are subject to a $50 processing fee.)

       Payment Methods:

        Print out form then click on the appropriate PayPal button:

        

PayPal Print out form then click on the appropriate PayPal button

Item Name: Regular Fee  Price $350

Item Name: Late Fee - Price: $400

Mail

Print out and mail the completed registration form with a check or money order to:

The Ferguson Literary Agency

5500 W. 133rd Terrace, #821

Overland Park, KS 66209

Attn: A Writer of Excellence Conference

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Copyright © 2005 The Ferguson Literary Agency. All rights reserved.
Revised: 08/31/05.