40th Annual Central States VHF Society Conference

July 27-29, 2006 - Bloomington, Minnesota

Name / Call
Spouse / Call
Address / Grid Square
City / State / Phone (Day)
Country / Zip / Phone (Evening)
Email Address / ARRL Member Yes No
What bands do you operate? (Please circle)
A / B / C / D / 9 / E / F / G / H / I / J
CW/SSB: / 50 / 144 / 220 / 432 / 902 / 1296 / 2304 / 3456 / 5760 / 10 GHz / 24 GHz
EME: / 50 / 144 / 220 / 432 / 902 / 1296 / 2304 / 3456 / 5760 / 10 GHz / 24 GHz
Satellite / HF / 145 / SNOTTSAT / 435 / 1269 / 2401 / 5670 / 10 GHz / 24 GHz
General Program
Description / QTY / $ US / Total
Society Dues 2006-2007 (required for each conference attendee) / $5 / $
Life Membership / $125 / $
Conference fee (each attendee, includes one copy of proceedings) / $40 / $
Conference fee (after pre-registration cut-off date of July 13, 2006) / $45 / $
Extra Proceedings (pickup at conference) / $20 / $
Extra Proceedings (mailed to your address) / $23 / $
Saturday Banquet (ham ticket) / ___Beef / ___Chicken / $32 / $
Saturday Banquet (family ticket) / ___Beef / ___Chicken / $32 / $
Life Member dues credit (subtract $5) / $ / -

Family Program

Description / QTY / $ US / Total
Thursday Evening Paddleford Boat Cruise w/ Catered Dinner (Adult) / $42 / $
Thursday Evening Paddleford Boat Cruise w/ Catered Dinner (Youth under 16) / $22 / $
Friday Mall of America All-Day Shopping Event / $6 / $
Friday Evening Scrap Book Workshop (36 participants max) / $10 / $
Saturday Morning Trolly trip to St Paul highlights– Adult (limit 30 participants!!) / $25 / $
Saturday Afternoon bus trip to Historic Fort Snelling ($8 entrance fee at door) / How many? / - / ------
Shirt Total from other side / $
Total Enclosed / $

See other side for important Questions and

Polo Shirts with CSVHFS embroidered logo!

Make check payable to: Central States VHF Society

Mail this form by July 13, 2006 with registration fee to:

2006 Central States VHF Society Conference
Jim Hermanek KØKFC
1213 207th St.
St. Croix Falls, WI 54024 / Make Hotel Reservations by July 1, 2006!!! Please register and make reservations early to assure accommodations. The number of rooms available at the low conference rate of $85 is limited. After that the rate increases sharply.

Conference Details: www.csvhfs.org Registration questions:

All other questions:

Are you bringing antennas for testing on the range? Bands:
Are you bringing pre-amps/xverters for testing on the Noise Figure Table? Bands:
Are you able to provide a family banquet prize? ___Yes ___No
Are you bringing your Rover for Rover Row? ___Yes ___No
Are you bringing a microwave dish system for the Dish Bowl? ___Yes ___No
May we share your info with other conferences? ___Yes ___No
I will need ____ tables during the Friday Night Fleamarket
I will need ____ tables in the Dealer Area (limit 4)
Do you have young family members wanting to enjoy the Youth Pizza Party on Sat Eve? Two babysitters chaperone event. How many youth? / #

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Product Description / Mens/Ladies / $$$$Price
COLOR / S / M / L / XL / XXL / XXXL / S-XL / 2XL / 3XL / Totals
Short Sleeve golf shirt w/ CSVHFS Logo
Gray / 16.00 / 18.00 / 19.50
Gray / w/ pocket / 16.00 / 18.00 / 19.50
Burgundy / 16.00 / 18.00 / 19.50
Burgundy / w/pocket / 16.00 / 18.00 / 19.50
See http://csvhfs.org for shirt images / Subtotal
Shipping is $5.00 + 1.50 per addt'l item / # of Items / Freight
Shipping is free if picked up at conference / Total

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Polo Shirts w/ embroidered CSVHFS Logo see http://csvhfs.org for images / QTY / $ US / Total
Gray Small / $16.00 / $
Gray Medium / $16.00 / $
Gray Large / $16.00 / $
Gray Extra Large (XL) / $16.00 / $
Gray Extra Extra Large (XXL) / $18.00 / $
Gray Extra Extra Extra Large (XXXL) / $19.50 / $
Gray Small w/pocket / $16.00 / $
Gray Medium w/pocket / $16.00 / $
Gray Large w/pocket / $16.00 / $
Gray Extra Large (XL) w/pocket / $16.00 / $
Gray Extra Extra Large (XXL) w/pocket / $18.00 / $
Gray Extra Extra Extra Large (XXXL) w/pocket / $19.50 / $
Shirt Shipping $5.00 + $1.50 for each additional item / $
Shirt Total—carry over to other side / $

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