First Name:      Last Name: 

  E-mail: 

  Phone Number:                Phone Number: 

How did you hear about this web site?

 Date/Time/Location of Requested Performance:

 Solo  (style of music)  

 Comic

 Other 

 Band   (name of band)

Number of musicians in the band              

Are all members over the age of 21    Yes No

Are all members over the age of 18    Yes No

Are any members under the age of 18 Yes No

Style of Music

Is anyone in your band difficult to get along with?  Yes  No

(If YES, please stop and close out this form.)

  How many original songs do you have?     

  How many 40-minute to 1-hour sets can you perform?            

  Enter your "My Space" web address:

  Enter other web address you may have:

  Where are you from?

  Where do most of your fans live?

  How many people usually come to see your show?                        

  Which performance nights would you prefer? Wednesday Thursday Friday Saturday Sunday

  What other bands or acts do you work well with?

  Do you object to the use of stage fog (Lighting for video is best when fog is used.)? No  Yes

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