Boskone 40 Order Form

____ memberships at $40.00: (price valid through January 19, 2003)

Total: $_____

Please make out check or money order (do not send cash thru the mail!) to Boskone. We also accept VISA and MasterCard.

I am paying $______ by: __ check/money order __ VISA __ MasterCard

Credit Card # ___________________________ Exp. Date: __________

Name on card: ______________________________________________

Signature: __________________________________________________

Name: _____________________________________________________
(Please attach additional membership names and addresses on separate sheets. Thank you!)

Address: ___________________________________________________

City: ____________________ State: _____ Zip/Postal Code: _________

Country: _________________ Email Address: _____________________

Please send me information about:

__ Joining NESFA

__ Obtaining space in the Dealers' Room

__ Volunteering to help

__ Entering my work in the Art Show

Mail to: Boskone 40; P.O. Box 809; Framingham, MA 01701; U.S.A.

Fax to: 617-776-3243 (only VISA and MasterCard on Fax orders)

Boskone is a registered service mark of the New England Science Fiction Association, Inc.

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