Keycon 2000 Artshow Registration Form

Artist / Agent: ________________________________________________________

Address: _______________________________________________________________

City: _________________________ Province/State: ________________________

Postal/Zip Code: __________________ Country: ___________________________

E-mail Address: ________________________________________________________

Phone Number: (_________)_______________________________________________

Fax Number: (_________)_________________________________________________

Reserve _____ Panels

        _____ Tables

        _____ Table Sections

I am the Artist _____ / Agent _____ / Owner _____ of the pieces I send.

Cheque _____ Money Order _____ Visa _____ Mastercard _____

Credit Card Number: ___________________________ Exp. Date: _____ / _____

Badge Name: ____________________________________________________________

Signature: _____________________________________________________________

To reserve your place in the art show, just print out this form,
and mail with your payment (cheque, money order, Mastercard or Visa,
please) to:

Keycon 2000
Attn: Art Show Director
P.O. Box 3178
Winnipeg, MB R3C 4E6
CANADA

To return to the art show page, click the "back" button on your browser.