Membership forms

Below is an HTML version of the membership form for Potlatch 10. Mail to the address listed.

Also available is a PDF file (which requires a copy of the Acrobat Reader), and a text version.

See the text version for British mailing address.

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Memberships in Potlatch 10 are $35 until 2/9/01, and will be $40 at the door. Supporting memberships are $10. Checks should be made out to Clarion West/Potlatch 10 and sent to:

Potlatch 10
c/o Mary Kay Kare
P. O. Box 3042
San Ramon, CA 94583

Name_________________________
Address________________________
_____________________________
E-mail address (optional)_______________
Phone (optional)__________________
Please contact me about my program idea __________________________________________________

____ Potlatch memberships at $35 each

____ Potlatch Supporting Memberships at $10 each.

____ Potlatch Banquet tickets at $20 each

$___ Total enclosed


Potlatch 10 is a non-profit literary convention for the readers and writers of speculative fiction. Proceeds benefit Clarion West, an intensive six-week workshop for writers preparing for professional careers in science fiction and fantasy.

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