Dealer Registration Form

MillenniumCon 11 Dealer Registration

Name Email

Phone City State ZIP

Company

Product Type

Company Website Link

Do you have a company Logo we could use?

Special Requests : Electrical, phone line, demo games, painting area, etc

Corporate Sponsorship

Table or Rack Space

Convention Support

Would you like to sponsor a game or tournament with prizes?

Would you like to donate prizes?

Would you like to run demonstrations?

Arrival Time if Known

How would you like to make payment?

Accommodations

If you need a room at the Wingate Inn and Conference Center, Millennium has a special convention rate of $87 per night. Indicate that you are with MillenniumCon when making the reservations. For more information on the Wingate Inn and Conference Center, go to the HOTEL section on the MillenniumCon website.

Thank you for completing the registration form. David Bennett, Vendor Coordinator, will get back with you as quickly as possible with further information and total cost based on the above requests.