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Name(s)_____________________________________________________________

City & State_________________________________________________________

E-mail address________________________________________________________

Phone Number________________________________________________________

Send form with check ($15 per person) made out to Dayton Disneyana to:

Plane Crazy Chapter - Disneyana Fan Club

c/o Gary Schaengold   

4 East Schantz Ave.

Dayton, Ohio 45409

FAX: (937) 293-9372

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You will receive an e-mail confirmation of early bird registration in a few days.

Remember!  Early Bird registration is limited to the first 50 registrations.

See you really soon!