QRPARCI Web Site 
 
Your Name:
First or Given

Last or Family
Seminar: @$41 Banquet: @$40
Callsign:
Name on Badge:
Email:

Telephone:
City: State/Country: Zip/Postal Code:

| 14th Tuesday | 15th Wednesday | 16th Thursday | 17th Friday | 18th Saturday | 19th Sunday |
Check bed required: 1 Bed: 2 Beds:

Plan to Stay at Holiday Inn?
$149.00 per night (includes breakfast). One night will be guaranteed with your credit card. Special Instructions: Please check the nights you wish to stay. Check the type of Bed/s. We will forward this information to the Hotel and they will assign a confirmation number. Once this is done, you will receive a note with your confirmation number (generally 7 days). You should contact the hotel with your credit card information within 7 days of receiving the confirmation number. Rooms not confirmed with credit card will be canceled and made available for reassignment.
Planing to stay at Homewood Suites: Suite rate 229.00 3 night minimum. We will forward this information to the Hotel and they will assign a confirmation number. Once this is done, you will receive a note from FDIM with your confirmation number (generally 10 days). You should contact the hotel with your credit card information within 7 days of receiving the confirmation number. Rooms not confirmed with credit card will be canceled and made available for reassignment.

ONLY registrations WITH Seminar or Banquet registration will be processed for the hotels.

Please help with our planning by completing these items.
I plan to participate in the Show and Tell
I plan to participate in the Homebrew Contest:
I am interested in spouse activities
Additional Registrants
Name:
First or Given Last or Family Call or XYL: Seminar: Banquet:
Name:
First or Given Last or Family Call or XYL: Seminar: Banquet:
Name:
First or Given Last or Family Call or XYL: Seminar: Banquet:
For the latest FDIM information, please visit http://www.qrparci.org
Questions, please contact Norm, WA4ZXV at fdim@qrparci.org

BE SURE TO CLICK ON THE RETURN TO MERCHANT LINK IN PAYPAL TO PROCESS YOUR REQUEST