OASIS 21

           Dealer Registration Form

Print,complete and mail with your check,
made out to:

     OASFiS
     P.O. Box 592905
     Orlando, FL 32859-2905


Business Name:________________________________

Dealer Name:__________________________________

Address:______________________________________

City:___________________State:____Zip:________

Telephone:_________________

email:________________________________________

Number of Tables:_____ X $60= $______

Extra Memberships:____ X $25= $______*

              Total enclosed: $______

Type of Merchandise:__________________________

Special Needs:________________________________

______________________________________________

______________________________________________
*Extra memberships are $25/ ea through 12/31/07
                       $30/ ea through 4/30/08
                       $35 after 4/30/08