REGISTRATION

To register, print or copy this form.

Mail overnight or priority to:

LLC2000 or Leather Leadership Conference
P.O. BOX 91997
WASHINGTON, DC 20090-1997



The full cost of the entire conference is $75.
($60 if registered by December 31, 1999

T-Shirt $15.  (Circle Size:  S M L XL 2XL 3XL 4XL)


We must have received your money before entry.
No money will be accepted by mail after the convention.


NAME:

ADDRESS:

CITY/STATE/ZIP

PHONE

E-MAIL

Are you (Circle One)
Attendee   Presenter

Special needs: (Circle)
Diet - Mobility - Sight - Hearing
Other
Details:


Organization/Affiliation.


Company Affiliation:

NAME:

TELE:

FAX:

E-MAIL:

May we use e-mail confirmation?      Yes   No
Do you need community housing?       Yes   No
Can you provide community housing?   Yes   No

Interested participants should send e-mail to: LLC2000 INFORMATION

Anyone who wants to be on the mailing list for the brochure and application to attend the conference should e-mail or send their name and address to:

        LLC2000
        P. O. Box 4494
        Woodbridge, VA    22194-4494