Registration Form

:

Fill in your registration information and print this form. (* Indicates required Fields.) Please also fill in separate forms for each person that you are registering. Send the form(s) and your registration fee to the following address:

First Name:*
Last Name:*
Badge Name:
Address 1:*
Address 2:
City:*
State:*
Zip Code:*
Phone Number:
Birth Date:*
E-mail:
URL:
Please send information on volunteering at DemiCon.
Please send information on entering the Art Show at DemiCon
Please send information on throwing a room party at DemiCon
Please send information on performing in the music room at DemiCon

Sorry, dealer tables are sold out!

Use your Browser to print this form and send it to the following address:

DemiCon 21
P. O. Box 7572
Des Moines, IA 50322-7572