JohnCon 2003 Dealer Form

Please note that, due to campus regulations, 
vendors are prohibited from selling weapons.
Thank you for your cooperation!

Name: _____________________________________________

Badge Name: _______________________________________

Store Name: _______________________________________

...................................................

Additional Badge Names 
(if purchasing more than one badge):

 __________________________________________________	

 __________________________________________________	

...................................................

Address: __________________________________________

City: ___________________ State: _____ Zip: _______

E-mail Address: ___________________________________

Phone Number: _____________________________________

...................................................

Number of Badges Purchased: _____ 

Amount Enclosed: $ ______________

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Number of Tables Requested: _____

Type of Wares: ____________________________________

 __________________________________________________

 __________________________________________________

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    Registration Rates

$ 9 Pre-Registration Fee if you register 
    before February 14, 2003 
$12 Registration Fee if you register 
    after February 14, 2003 
$12 Registration Fee at-the-door
...................................................


Mail this form with payment to:

JohnCon '03
SAC Office
Johns Hopkins University
3400 North Charles Street
Baltimore MD 21218