Tut-Kalifornia Esperanto-Konferenco en 2005 [TKEK-2005]

25-27 februaro, 2005

(vendredon vespere ĝis dimanĉo tagmeze)

en bela Santa Barbara, Kalifornio, Usono

APPLICATION FORM (select and print only the form)

Your name(s) - please print_______________________________________ Phone: __________ 

Address:____________________________________________________________________________
(Street/Post office box City State E-mail)

Enclosed is my registration fee [includes buffet dinner]. 

$40 each for____persons.................................................... $_______

Choose vegetarian___ or non-vegetarian ____ (how many of each?) 

Please reserve _______ extra dinner-tickets @ $18 ......................... $_______

Choose vegetarian___ or non-vegetarian____ (how many of each?) 

Enclosed is $5 for the basic___ intermediate__ advanced__ examination ..... $_______

Total enclosed: ........................................................... $_______

Address your check/money order to ESPERANTO CONFERENCE 
and send it with this application to:

          5243 University Dr.
          Santa Barbara CA 93111-1732 

before Feb 11, 2005. 

*I would like to make the following presentation(s); 

Morning or afternoon discussion/lecture re __________________________________________ 

Saturday evening after-dinner entertainment: ________________________________________ 

Sunday-morning presentation:_________________________________________________________ 

I would like a less expensive room in another hotel ____ ; home hospitality ____ 

Questions? Contact Dorothy Holland (805-967-5241 )