THE INDIANA
STATE NUMISMATIC ASSOCIATION
53RD ANNUAL COIN
SHOW AND CONVENTION
TO BE HELD AT THE INDIANAPOLIS MARRIOTT
7202 EAST 21ST STREET, INDIANAPOLIS,INDIANA
IN LIBERTY HALL
NOVEMBER 3,2011(DEALER SETUP)SHOW DATE IS NOVEMBER 4-5,2011
PLEASE PRINT DISTINCTLY
Dealer’s
Name___________________________________Phone____________________
EMAIL ADDRESS-REQUIRED IF YOU HAVE ONE.__________________________________
Address________________________City_____________State_________Zip________
NAMES
OF DEALERS BADGES PLEASE PRINT
NAMES BELOW
___Eight foot tables @ $295. (2 badges)
________ _____________________
___Corners with 2 tables @ $395.00 (3 badges)________ _____________________
CORNER TABLES ARE SOLD OUT.
___Extra Badges @ $25.00 EACH
________ _____________________
___Display Cases @ $10.00 EACH
________ _____________________
___Lights @ $5.00 EACH
________ _____________________
Total
Amount Due__________Amount submitted ( $50.00 MIN.)__________PAY TO: ISNA
BALANCE DUE OF $ ON OR BEFORE OCTOBER 1,2011. MAIL TO:JOYCE FISCHER, 1123 HISTORIC WEST 8THSTREET,ANDERSON,IN.46016-2616.EMAIL:Kycolonels@comcast.net;
PH: 765-649-0253. Applicant agrees to assume all risk of
loss, damage or injury, by fire, theft or otherwise to person or property by reason of the condition of the bourse area, or
by reason of the management, control or operation thereof, and releases ISNA, their successors and assigns, from all claims
for such loss, damage or injury sustained by the dealer, or by any employees of the dealer or by any persons whomsoever, whether
caused by the negligence of ISNA, its agents or assigns, or otherwise and the dealer agrees to indemnify ISNA, their successors
and assigns against all claims for such loss, damage, or injury, sustained by the dealer or by any agent or employees of the
dealer, or by any person whomsoever. Applicant agrees to provide all licenses
and permits and to obey all applicable statues and ordinances.
THANK YOU FOR PARTICIPATING IN OUR 2011 STATE SHOW
ATTENTION DEALERS
PLEASE MAKE SURE YOU HAVE PROVIDED PROPER LEGIBLE BADGE NAMES ON
THE LINES PROVIDED ABOVE. IF REQUIRED NAMES ARE NOT PRESENTED OR CHANGED PRIOR
TO OCTOBER 1,2011. YOU WILL BE CHARGED AN ADDITIONAL $25.00 PER BADGE AT THE
TIME OF REGISTRATION. BOURSE APPLICATION CANNOT BE ACCEPTED UNLESS PROPERLY SIGNED ON THE REVERSE SIDE.
DEALERS--PLEASE MAKE SURE YOU HAVE YOUR TABLE DEPOSIT, AND/OR FULL BOURSE PAYMENT IN BY JUNE 1, 2011.. NO
EXCEPTIONS. IF A DEPOSIT IS NOT RECEIVED BY THE JUNE 1. 2011 DEADLINE YOU WILL
LOOSE YOUR CURRENT LOCATION.
