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

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
Badge Name
Address
City
State
Zip
Phone
Email
Membership 2
Name
Badge Name
Address
City
State
Zip
Phone
Email
Membership 3
Name
Badge Name
Address
City
State
Zip
Phone
Email
Submit
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