Lunacon 2017 Art Show Reservation
This form is for payment by credit card only. To pay by check or money order, print out our PDF application from our website, complete and mail with your payment.

I understand that my submission of this signed and dated LUNACON 2017 Art Show Reservation Form signifies that I have read and accepted the Art Show Rules provided with this form.

Artist Signature
Your answer
Date
MM
/
DD
/
YYYY
Artist Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
E-mail address
Your answer
Agent Name
Your answer
Address
(if different)
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
E-mail address
Your answer
My art will arrive with
Make checks payable to
(if different from Artist Name)
Your answer
Credited Press Photography Allowed?
Send bid & control sheets in mail?
Put on Wait List if no space/not all space requested available?
Panel Space
Table Space
Electricity Needed?
Print Shop
Total # of prints
Your answer
Any special requests?
Your answer
Art Show Fee
(total panels and tables) $
Your answer
Print Shop Fee
(total panel space) $
Your answer
Mail-In Fee
(only if mailing in art) $
Your answer
Return Postage
(Mail-In ONLY) $
Your answer
Lunacon 2017 Membership(s)
$
Your answer
Adult @ $60
Your answer
Child 6 to 12 @ $30
Your answer
Student/Young Adult(13-25)/Active Military @ $40
Your answer
These rates good through 03/17/2017 (include names & addresses for additional members at end of form)
Total Amount Due
$
Your answer

If you are paying by credit card, you will be given a secured online link and password with your space confirmation to make your payment. You will then have 10 (ten) days to make this payment before your space is assigned to someone else. We cannot accept payments through PayPal.
Lunacon 2017 Membership/Registration List
Membership 1
ow Name
Your answer
Badge Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
Email
Your answer
Membership 2
Name
Your answer
Badge Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
Email
Your answer
Membership 3
Name
Your answer
Badge Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
Email
Your answer
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