2024 Registration Form -- Not Using PayPal "*" indicates required fields Contact InformationPlease note: We ask that you submit a separate registration form for each person in your group attending the 2024 convention.Name* First Last Callsign* If registrant has no callsign, enter NC instead.Age Group* 16 and Under 17 to 24 25 and over Let us know if you qualify for our Teen or Youth discount programs. Is this your first time attending a PNW DX Convention?* Yes No Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Meal and Program OptionsNOTE: All pricing in US dollars.Early Bird Pricing has EXPIRED. Prices listed below are the Full Conference Prices.In order to ensure you receive the correct pricing, please select your age group above, before selecting your program options.Meal and Program Options* Complete Convention and Meal Package - $195.00 A la Carte (choose individual convention options) Meal and Program Options (Youth)* Complete Convention and Meal Package - $90.00 A la Carte (choose individual convention options) Meal and Program Options (Teen)* Complete Convention and Meal Package - $60.00 A la Carte (choose individual convention options) A la carte Convention ChoicesChoose individual activities -- great for those who can't attend all the events. Friday How-To sessionsIncluded in full program. Select if attending Friday session only. Saturday Program and General Attendance $100.00Includes Saturday program Saturday Banquet Dinner $90.00Make your dinner selection below Sunday Buffet Brunch $40.00A delicious brunch, served buffet-style with an assortment of options at the buffet table Hospitality Suite $35.00Access to the Hospitality Suite A la carte Convention Choices (Youth)Choose individual activities -- great for those who can't attend all the events. Friday How-To sessionsIncluded in full program. Select if attending Friday session only. Saturday Program and General Attendance $45.00Includes Saturday program Saturday Banquet Dinner $40.00Make your dinner selection below Sunday Buffet Brunch $20.00A delicious brunch, served buffet-style with an assortment of options at the buffet table Hospitality Suite $35.00Access to the Hospitality Suite A la carte Convention Choices (Teen)Choose individual activities -- great for those who can't attend all the events. Teens get free admission to the event and pay only for meals. Saturday Banquet Dinner $40.00Make your dinner selection below Sunday Buffet Brunch $20.00A delicious brunch, served buffet-style with an assortment of options at the buffet table Saturday Banquet Dinner Selection* Garlic and Herb Grilled Chicken BreastServed with creamy Dijon, roasted asparagus, and garlic mashed potatoes Seared HalibutServed with lemon caper sauce, rice pilaf, and roasted vegetables New York Strip LoinServed with port wine sauce, roasted red potatoes, and roasted vegetables VegetarianOur chefs are working on the Vegetarian menu. Contact for details. Please choose your meal for Saturday. All meals include Organic Green Salad and New York Cheescake.If you have special dietary requirements, please contact us so we can work to accommodate your needs.Hospitality Room Donation (Optional) No thanks $5 $10 $15 If you would like to contribute to the awesomeness of our Hospitality Room, please select an amount above.Total (US dollars) Let us know how you prefer to pay your fees* I will send a cheque/check by mail I will pay fees in person with cash or cheque/check at the convention in August Next StepsAfter you submit the registration form: A copy of this information will be emailed to you for your records. Your registration will not be complete until payment is received by the Western Washington DX Club.Make your check payable to: Western Washington DX Club Mail payment to: Western Washington DX ClubPO Box 395Mercer Island, WA 98040Cancellation PolicyIf any government authority prohibits in-person meetings at the time of the Convention, a full refund of the Convention Fees will be made. Any arrangements you make with the Delta Hotel by Marriott (the Convention's hotel) are between you and the hotel. Those things are beyond our control. If you register and pay your Convention fees prior to July 9 and then decide not to attend, if requested, we will refund you 50% of your Convention Fees. If you cancel after July 9, no refunds will be provided. Δ
