Westercon 72, NASFiC 2019, and 1632 Minicon Membership & Permissions Form
The combined conventions, nicknamed Spikecon, is a Regional and North American event July 4-7th, 2019, in Layton, Utah. Use this form to submit missing membership information, or to update information on an existing membership. You can purchase a membership online at: https://www.spikecon.org/attending/get-a-membership

Not all of the questions here may apply. Email registration@spikecon.org for further questions. Payments can also be emailed through PayPal to payments@utahfandom.org or post mailed to: Utah Fandom Organization (UFO)
PO Box 201 Clearfield, UT 84089

Full Name *
Your answer
Mailing Address/City/State/Country/Zip or Postal Code
Your answer
Phone
Your answer
Email
Your answer
May we publish your name as a member on our member lists and in the souvenir book or other convention material?
Do you want to be added to our Mailing List for up to date electronic correspondence?
Would you like to volunteer for the 2019 event?
Published Name
Your answer
Badge Name
Your answer
Do you have an existing membership/number?
What is the membership number/name on the original registration?
Your answer
To reduce costs, our Progress Reports will be distributed electronically to our mailing list and will be posted in pdf format at www.spikecon.org. Are you requesting another format?
What type of membership do you have, or are requesting changes to?
Billing Name if different on payment
Your answer
Secondary membership information
Your answer
Comments or Questions?
Your answer
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