Online Registration Form

Kansas Barbed Wire Collectors Association

Barbed Wire Swap & Sell May 4-5, 2012

La Crosse City Auditorium - 417 Main Street - LaCrosse, Kansas

Online Registration Form

Personal Information:

Event:

KBWCA Swap & Sell 2012

Date:

May 4-5, 2012

Name:*

Address:*

Address 2:

City:*

State:*

Zip:*

Phone:

Work or Mobile:

Email:*

*(Required Information)

Membership Information: (Membership or table rent required to be eligible for display judging)

Individual $25.00

Family $50.00

Sustaining $100.00

Lifetime $1,000.00

Renewal (Annual May 1)

I wish to make an additional donation to the museum: $

Trade Tables & Display Space:

Inside Display Space Number of Tables: $15/table	Display Space (linear feet):**	Electrical Hookup
Outside Display Space (outside booths reserved for antique and craft vendors - need to supply your own tent) Number of Booths: $10/booth
**Display Space along inside wall: no charge to members - free with table rent (as space available)

Special Requests:	Along Wall	Center Aisle	Near Front	Near Loading Door	Center End Cap
Every effort will be made to accomodate you, however requests will be honored on a first-come basis.

Special Events:

Evening Cookout - CANCELLED:

Number Attending:

Ticket Price: CANCELLED

Saturday Evening Banquet:

Number Attending:

Ticket Price: $12.00 per person

Survey Information (optional):

This is my first time at the LaCrosse show

This is my first time at ANY barbed wire show

How did you hear about us?
Webpage	"The Collector"	Newspaper/Magazine	Word-of-Mouth	Other:

You will receive a confirmation and billing statement under separate cover.

Registration Options:
On-line	By Mail	By Telephone
To complete registration on-line, fill out this form on your computer and press submit. Your registration will be e-mailed to us. You will receive a confirmation. PRESS SUBMIT ONLY ONCE.	Complete this form on your computer, print and mail to: Kansas Barbed Wire Collectors Association P.O. Box 526 LaCrosse, KS 67548	You may make phone reservations by calling: reservations not available see you next year
Payment Information:
No payment is required in advance. You may pay at the registration desk during the show. Balance due must be paid by 12:00 p.m. on Friday of the show.
Reservations will be held until 12:00 p.m. on Friday unless other arrangements have been made.