Personal Submersibles Organization
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2004 PSUBS Convention
Registration Form
(See http://www.psubs.org/convention/2004/ for Convention details)
Registration:
Name:________________________________
Address:_____________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
Phone Number:_______________________________
E-Mail:_____________________________________
How many staying at the Courtyard at Marriot in Hillsboro, Oregon (for informational purposes only):_____________
Bringing Sub: YES NO 1ATM Ambient Name:_____________________________
T-Shirts*
Size Quantity
XXL ________
XL ________
L ________
M ________
S ________
Total Quantity ________
* T-Shirts are optional. Calculate costs in next table.

Costs**
Items Quantity Cost Total
Friday, 20 August 2004 Field Trip to
Underwater Warfare Museum in Keyport, Washington***		 ________ $30 USD per person ____________
Saturday, 21 August 2004 Conference in Hillsboro, Oregon ________ $50 USD per person ____________
Hats ________ $15 USD per Hat ____________
T-Shirts ________ $10 USD per T-Shirt ____________
Shoulder Patch ________ $5 USD per Shoulder Patch ____________
Total $____________
** Two week cancellation notice is required for full refund.
*** In the event that the trip to the Underwater Warfare Museum
does not pan out, a Meet and Greet Picnic will be held instead. The cost will be
$10 each with the balance of $20 each being refunded.

Payment:
Send check or money order made out to Ray Keefer to:
Ray Keefer
PO Box 586
Gaston, OR 97119

Rev 2.1 30 Jul 2004 rk