Noreascon Four Membership Transfer Form

I am using this form to transfer my Noreascon 4 membership to the person named in the "New Member information" section below.

Current member information

Membership number:		(Use our Membership Search to find your number if you don't know it.)
Name
Address:
Address:
City:		State/Province:
Zip/Postal Code:		Country:
Email:		Phone:

New Member information

Name:
Address:
Address:
City:		State/Province:
Zip/Postal Code:		Country:
Email:		Phone:

Please note: Memberships include the right to vote in the Hugos & Site-Selection. When you transfer your membership, you no longer retain these rights. If you have already voted for the Hugos and/or Site-Selection, the person to whom you are transfering this membership will not have the right to vote.

Please help us by letting us know if you have already voted.

I already voted for the Hugos or Retro-Hugos.
I already voted for Site-Selection.

Signature: _______________________________________ Date: _________

Do not email this form to us; we must have your signature on the transfer form for our records. Please print, sign and date this form then give or fax it to the person to whom you're transferring your membership so that they can bring it to Registration.