Press the button to SUBMIT.
Pay the fee of $75 by sending a check to the WFCRP Registrars, 4801 Broad Brook Ct., Bethesda, MD 20814.
A ZOOM invitation to the Conference will be sent to you along with your assigned Interest Group a few days before the Conference.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Preferred phone

(###)

###

####

Interest Group Choice

2nd Interest Group Choice

Select a 2nd option in case 1st is filled - if you opt out just pick #5 again.

3rd Interest Group Choice

Select a 3rd option in case 2nd also ifilled - if you opt out just pick #5 again.