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Enter name as you want your badge to appear. * Required fields.
First name: Last name:
* *
Street address: Additional address info:
*    
City: State or Province: ZIP/Postal Code:
* * *
How would you like us to contact you (e-mail, phone, mail or all)?
e-mail    
telephone     nnn-nnn-nnnn
mail
Enter additional names (and their relationship to you: Spouse, son, friend, etc) in this space, separating
each with a comma. Example: Mary Doe, wife, John Doe, son, Jack Daniels, friend.
The following information is requested of those who are bringing modules:
         Scale:          Module Size (in feet):   Width -    Length -
        Interfacing with others? Yes No If YES; Who?
        Will you require a Power Pack? Yes No An Extension Cord? Yes No
Any other requirements?
Will you be attending for the weekend or Saturday only? Weekend Saturday only
* How many registrants? (Include spouse and children)
How many spouses in your party? (No charge)
How many children under 16? (No charge)
Registration Fee: $
The following information is requested of Dealers and others who may have items for sale:
NOTE: After April 1st, 2008, Table Fees double to $30 & $24.
Will you provide a door prize, in the form of merchandise or a gift certificate?
Yes No
Tables required: First table is $15.00.
Each additional table is $12.00 per table. Table size is: 8 x 2.5 feet.
Dealer Name (if any)
Special requests: Away from wall, hall location, electric, etc.

Table Fee is: $
TOTAL FEE is: $
Please make check or money order payable to: Robert J. Beebe. Thank You
How did you learn of the Mid-Atlantic Narrow Gauge Guild and our annual Module Meet?
Check all that apply:   Flyer   Internet Search   Train Show   Friend
Magazine:
Other:
Thank you!                 

Click 'Send', then print out the form (your copy) and mail a check or money order to: Robert J.Beebe, 712 Meadowlark Rd., Norristown, PA 19403. If you wish to receive acknowledgement of your registration by mail, please include a SASE. Those registering on-line will be emailed, if a valid email address is included. Should you have any question regarding this form or the Module Meet in general, contact Bob Beebe at jrbeebe@verizon.net.

For a printable form, check here
Note: This form is a Microsoft Word Document.

Mid-Atlantic Narrow Gauge Guild c/o R.Beebe, 712 Meadowlark Rd. Norristown, PA 19403
Updated - February 11, 2008