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Print Form

November 4th, 5th, 6th and 7th


Philadelphia, PA

Registration Form

________________________________________________________________________________
Name

________________________________________________________________________________
Address

____________________________ _____________ _____________ ___________________


City State/Province ZIP/Postal Code Country

________________________________________ ______________________________________
Email Adress Telephone Number

Panelist Writer Fan Collector

Friend/ Publisher Other


Family
Rates:
$180 (Award Banquet included) BEFORE December 31, 2009
$200 (Award Banquet included) AFTER January 1, 2010
$50 (Award Banquet for Spouse of Registrant)

Total Amount Remitted; _________________________

Paid by Check or Credit Card (Visa, Master Card, Amex) No.:___________________________

Exp/Date:_______________________

Mail this form with your check made out to NOIRCON 2010/ Society Hill Playhouse to:

NOIRCON NoirCon Hotel: Doubletree Hotel, 237 South Broad


c/0 Society Hill Playhouse Street Philadelphia, Pennsylvania 19107-5686
507 South 8th Street
215-893-1600. $149/Night
Philadelphia, PA. 19147
Book early. Rooms are limited at the convention rate.
Call (215) 923-0211 for more information.

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