DEALER  REGISTRATION FORM

[FrontPage Save Results Component] First Name Last Name Business Name Tax ID Number Street Address   City State Zip Email Address / URL Home Phone  Business Phone  Brief Description of Your Goods: PLEASE INDICATE THE RENTAL SPACE(S) YOU PREFER. (NO REFUNDS FOR CANCELLATIONS) LOCATION SIZE (L x W) AMOUNT DEPOSIT DANCE HALL BANDSTAND (9a & 9b) $ 250.00  (each) $ 175.00 DANCE HALL CORNER $ 500.00 $ 250.00 DANCE HALL 10 x 12 $ 275.00 $ 175.00 PAVILION 15 x 20 $ 200.00 $ 125.00 PAVILION 12 x 16 $ 200.00 $ 125.00 PAVILION 10 x 16 $ 175.00 $ 100.00 PAVILION 16 x 10 $ 175.00 $ 100.00 INSIDE DEPOT 8 x 10 $ 225.00 $ 150.00 DEPOT PORCH 10 x 10 $ 175.00 $ 100.00 NEXT TO PORCH 12 x 20 $ 125.00 $  75.00 UNDER ANTIQUE TENT 16 x 14 $ 275.00 $ 175.00 HWY OUTSIDE SPACE 12 x 20 $ 125.00 $  75.00 A&C OUTSIDE SPACE 12 x 20 $ 100.00 $  50.00 PLEASE INDICATE THE ADDITIONAL SERVICES YOU REQUIRE: TENT?                Yes  No      SELECT SIZE: Select 10 x 10 12 x 20 20 x 20 (TENTS ARE PROVIDED AS A COURTESY TO OUR VENDORS) SIDE PANELS? Yes  No      QUANTITY:    Select 1 2 3 4 (SIDE PANELS ARE $ 5.00 PER SIDE) RV SPACE?       Yes  No      NUMBER OF NIGHTS:    Select 1 2 3 4 5 6 7   RV SIZE:     LICENSE NUMBER:  (RV SPACES ARE $15.00 PER NIGHT) By submitting this form, Dealer is accepting the invitation to exhibit at the Old Depot Antiques & Collectibles Show and Sale.  Dealer releases and will hold harmless all persons involved in the organization and also property owners for loss of or damage to Dealer's merchandise and/or equipment, and for any personal injuries to Dealer, Dealer's employees, or the public.  Dealer additionally recognizes that Old Depot Antiques & Collectibles cannot be responsible for weather conditions or dealer cancellations.  Dealers are responsible for having their own sales tax number, and reporting sales tax for their sales. IMPORTANT NEWS FOR OUR VENDORS: Effective January 1, 2000 the city of Round Top, Texas began requiring all Antique and Collectible Dealers to purchase a $10.00 permit per Dealer, per show.  Old Depot is now required to collect this permit fee in addition to your other dealer registration fees.  We apologize in advance for any inconvenience this new requirement may cause.  Please note that Dealers choosing to arrive and set up more than one week prior to any show date will be required to pay an additional rental space premium. NO REFUNDS FOR CANCELLATIONS ALL BALANCES MUST BE PAID IN FULL 30 DAYS PRIOR TO SHOW