Dundracon Dealer Room Submission form

Fill out this form and send it to: Dealers@Dundracon.com

Company Name: 
Contact Name: 
E-mail: 
Postal Address:
Street: 
City:  
State: 
Zip Code:

Phone: 

Type of Merchandise: 

Company Website: 

If you wish you may send a company logo or banner to use on 
our website and in the convention book to: Webmaster@dundracon.com 

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Table Preferences
Number of tables: 
Preferred table(s):
Dealer's Room Map 

A/V needs (Electricity, Phone Lines, Wired/Wireless Internet, etc. Additional expenses may be charged): 

Special Requests:
 
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Please include the following information for each badge requested:

Name:  
Badge Name: 
Type of Membership:  [Full Membership] [Dealer Room Only] 
E-mail: 
Postal Address:
Street: 
City:  State:  Zip Code: 

Emergency Phone: 
Cell Phone: