Testing New Convention Form ICCC Convention Registration FormPlease enable JavaScript in your browser to complete this form.Name *FirstLastMembership Number *ICCC membership numberAddress *IMPORTANT: Please enter your FULL postal address, including ZIP/Postcode and Country.Email *EmailConfirm EmailPhone Number (primary) *Phone Number (secondary)This is my first ICCC convention *YesNoAttendance *Single (1) $20.00Couple (2) $30.00Family (3) $40.00Family (4) $50.00Family (5) $60.00Family (6) $70.00Additional informationPlease add the names of the other people in your party if you are attending as a couple or family.Additional Late Fee $10 from June 1, 2021 *I don't need to pay the late fee as I'm paying before June 1I agree to pay the $10 late feeI want to reserve the following number of 8’ sales tables (at $20 each) *I want to reserve the following number of 8’ display tables (at no cost) *I have a special requirement (please state)I want to reserve the following places at the Friday Night Banquet ($35 per person standard meal) *Friday Night Banquet at the Frank Fickett Scouting Center in Austin: Dinner will be buffet style and includes Chef Carved Roast Beef and 12 Spice Chicken. Additional menu items include: garden salad, buttered rosemary potatoes, green bean almandine, rolls & butter. Desert will be assorted mini cheesecakes and beverages are included. A vegetarian option is available (please reserve below).I want to reserve the following places at the Friday Night Banquet ($35 per person vegetarian meal) *Please indicate if you want to order the vegetarian meal instead. This is IN ADDITION to the number already ordered for the standard meal.Payment Method *I am paying by check in USD to ICCCI am paying with PayPal to icccpaypal@intlccc.net and will add 5% to cover costsGDPR Agreement *I consent to having this website store my submitted information so they can process my inquiry.Submit