Warpstock 2001 - Toronto, Ontario Canada Holiday Inn Select Toronto Airport October 6 - 8, 2001. __________________________ MAIL-IN REGISTRATION FORM To mail in your registration, please fill out this form and send it in with a check or money order MADE OUT TO "WARPSTOCK, INC." Send it to the following address: Warpstock 2001 - C/O Stan Sidlov 187 Hilltop Court Pompton Lakes, New Jersey 07442 United States of America Please note that September 15th, 2001 is the cut-off date for mail-in registrations. NAME : ___________________________________________________________________ E-MAIL : _________________________________________________________________ STREET ADDRESS : _________________________________________________________ CITY : ___________________________________________________________________ STATE OR PROVINCE : ______________________________________________________ POSTAL CODE : ____________________________________________________________ COUNTRY : ________________________________________________________________ NR OF VENDOR REGISTRATIONS (US $500, including 2 free admissions) : __________ NR OF REGISTRATIONS (US $90 until 09-01-01, $120 afterwards) : _______________ NR OF SOCIAL EVENT (US $50 per person) : ______________________________________ What would you like to have printed on your Warpstock badge ? BADGE 1 NAME : ___________________________________________________________ CITY, STATE : ____________________________________________________ INFO : ___________________________________________________________ BADGE 2 NAME : ___________________________________________________________ CITY, STATE : ____________________________________________________ INFO : ___________________________________________________________ ********************