MSNS Fall 10
Fall Convention & Coin Show
November 26, 27, 28, 2010
Hyatt Regency,
APPLICATION FOR BOURSE TABLE
Please sign and return immediately
NOTE: This application must be accompanied by a $100 deposit made payable to MSNS. Any forms received without the deposit will be returned and no table reservation will be made. Be sure to sign and date below.
Dealership Name _____________________________________________ MI Tax # __________________
Applicant Name ___________________________________ MSNS Member # __________________
Business Phone (___) _________________ Fax (___) __________________ E-Mail Address_____________
(1) Assistant Name ___________________________
MSNS Member # _____________or New Member_____@ $10.00
Same as above_ or Address________________City___________ST______ZIP_____or
Renewal 2011_____@ $10.00
(2) Assistant Name ___________________________
MSNS Member # _____________or New Member_____@ $10.00
Same as above_or Address_________________City___________ST_______ZIP_____or
Renewal 2011____@ $10.00
No more than two assistants are allowed per Bourse Table. All
assistants must be current MSNS members in good standing. Any assistant changes
at the Convention can be made only after
Are you a member in good standing of the
American Numismatic Association? ___ Yes ___ NO
Have you ever been suspended or expelled from
the ANA? ___ Yes ___ No (It is MSNS policy to refuse Bourse table
space to any person who has been either suspended or expelled by the ANA.)
This application may be canceled and any payment refunded, if written notice is given the Bourse Chair at least 30 days prior to opening of the Convention; otherwise, payment will be forfeited.
SHOWCASE RESERVATIONS: One case is free with each table, however, if not indicated, no case will be provided.
Free case: ___ Yes ___ No Additional cases at $10.00 each? __ (in addition to free case.)
TABLE LAMP RESERVATIONS: No table lamps are provided without cost. Table lamp rental is $10.00 per lamp for the duration of the show. Number of lamps at $10.00 each: _____
Each dealer Bourse space has one eight-foot table and complete backup facilities; no auxiliary or additional tables are allowed. No wall signs allowed. Dealers are limited to the display of no more than 25% non-numismatic items on the Bourse table. In the Annex Room, this limit is 50%, but Annex tables are sold only after the main Bourse is full.
I prefer the Main Room ____ or the Annex Room______.
DEALER WAIVER, RELEASE FROM LIABILITY
I hereby release the Michigan State Numismatic Society, all participating clubs and their officers, members, committees, agents and employees, in their official and/or individual personal capacities, from any liability for loss, damage, or destruction, through negligence or otherwise, of any numismatic material, and for personal injury and property damage of any kind, which the undersigned may suffer or incur before, during or after this Convention. The foregoing shall not, however, limit the liability of any individual who may personally be guilty of theft, willful damage or destruction.
The undersigned, in applying for Bourse space, hereby agrees to accept the space allotted, and to abide by all the rules and regulations of the Michigan State Numismatic Society, the committees, the Hyatt Regency Hotel, the City of Dearborn and the State of Michigan. I also will adhere to the MSNS code of ethics. I understand that no food or drink may be sold at my table.
Tables may NOT be transferred, sold, leased, shared or sublet, in whole or in part, without approval of the Bourse Chair. No dealer will be assigned more than one table unless space is available. Dealer badges will be issued only to those listed and any last-minute changes will be considered only after the official opening of the Convention. Only those with Dealer badges and Assistant badges are allowed behind a Bourse table.
Michigan State Numismatic Society reserves the right to refuse a table to anyone or company for any reason without liability, also we reserve the right to deny a dealer’s assistant credentials to be behind the table. We also have the right to assign table locations without recourse.
CAUTION:
THIS APPLICATION CONTAINS A RELEASE FROM LIABILITY, READ BEFORE SIGNING!
Signature of Applicant: _____________________________ Date ____________________
Mail this Application to: PLEASE REPLY
BEFORE:
Joseph H. Le Blanc, Secretary/Treasurer
(734) 453-0504 FAX (734) 453 4475 jhl@michsoft.com
NOTE:
ALL BOURSE AND MEETING AREAS ARE NON-SMOKING AND ALCOHOL IS PROHIBITED
Table Fee Main Room paid in full before Sept.
15 Qty._________@ $350.00 =
__________
Table Fee Main Room after Sept. 15 Qty._________@ $395.00
= __________
Table Fee Annex Room paid in full before Sept.
15 Qty. _________@ $350.00 =
__________
Table Fee Annex Room after Sept. 15
Qty._________@ $395.00 =
___________
Lamps Qty._________@ $10.00 =
___________
Cases
Free____ Qty._________@ $10.00 =
___________
Membership Reg._____
Qty._________@ $10.00 =
___________
Junior____
Qty._________@ $5.00 = ___________
Deposit Cash_____ Check
#_________ =
(_________)
Balance due by
If not paid in full by