OASIS 29 Dealer Registration Form

$75 per 6 foot table (each table includes 1 membership)
Additional memberships are currently $40 each.

Instructions
1. Fill out form.
2. Pay with Credit Card or PayPal.
2Checkout.com is a worldwide leader in online payment services
3. Pick up your badge at the convention.

Contact Information

Business Name
Dealer Name
Address
City
State
Zip
Phone #
(Enter phone # without dashes or spaces i.e. xxxxxxxxxx)
E-Mail
Your email will be used to relay event information only.

Please Select Number of Tables and Additional Memberships

Number of 6 foot tables at $75
(each table includes 1 membership)
  • 1
  • 2
  • 3
  • 4
Number of extra memberships
(currently at $40 each.)
  • None
  • 1
  • 2
  • 3

Type of Merchandise and Special Needs

Type of Merchandise
Special Needs (No guarantee we can comply)