Membership for DREAMATION 2001 is $25.00 until Friday, May 18, 2001 (at midnight). Please use the following form to register. You will be sent a confirmation eMail within 2 days and the schedule of events via eMail when it is ready (probably the first week of May). Note that if you are joining The Avatar System for the first time, you will need to use the Character Registration Form and pay the $15.00 annual Avatar System fee separately.

If you are using a credit card, please enter your name as it appears on the credit card, and the address that the credit card bills are sent to.

Name:

eMail address:

Street Address:

City: State: Zip Code:

Phone (daytime):

Phone (after 6PM):

Please choose a method of payment:

Credit Card via eMail: Please note that this is NOT a secure form. If you do not wish to submit your credit card information with a non-secure form, please choose the next option.
Credit Card via Phone: Once you've submitted this form, please call Double Exposure at (914) 328-3740 and leave your credit card number and expiration date.
Check: Once your form is accepted, an eMail will be sent to you with instructions on where to send the check with payment for your Avatar. Please note that unlike the first two methods, you will not be considered registered for DREAMATION 2001 until your check clears.

If you are using method one, please fill in the following information:

Mastercard
Visa
Discover
We're sorry, but we do not accept American Express at this time.

Credit Card Number:
Credit Card Expires (00/00):

Additional comments: