Your Contact Information:
	Name Of Artist, Act or Talent:  * required Your Name:  * required City/State:  * required Phone Number:  * required E-Mail:  * required Website:
Tell Us About Your Act:
Type Of Act/Performance: Please Explain Your Act/Performance: Number Of Persons In Your Act: I Am A:	* required 1 2 3 4 5 6 Part-Time Performer Full-Time Performer
How Many Years Experience:
Performance Availability:
	I Am Able To Perform: Locally Regionally Nationally
	What Are The Primary Markets You Are Currently Working? Are You Currently Listed With Any Agencies? If Yes, Please List: Are You Currently Working The School & College Market? Yes No If Yes, How Many Bookings Per Year? Please Select Associations That You Are A Member Of: NACA APCA Are You Listed With Any Agencies For Representation In The School & College Market? If Yes, Please List: Are You Currently Working The Fair & Festival Market? Yes No If Yes, How Many Bookings Per Year? Is The Fair & Festival Market Of Interest To You? Yes No What Are Your Agency Rates/Pricing?  * required What Are Your CO-OP Or Block Booking Rates?  * required Do You Carry Performer's Liability Insurance? Yes No What Technical Or Show Requirements Are Needed? Do You Travel Self-Contained With Your Own Sound System? Yes No Do You Have Professional  Promotional Photos (8"x10")? Yes No Do You Have Professional Promotional Materials? Yes No If Yes, Please Explain: Do You Have A Demo DVD? Yes No