Fill out form below or Call 1 608 554 1935
Email Address
 *(required for form processing)
Your Name:
Organization:
Phone:
Street address:
City:
State/Province:     Zip code:
Country:
Date Of Event:

What type of event are you
 hosting or coordinating?

 

  
(If you chose other please specify here)

Which entertainers would you
like to perform at your event?
 hold control key down to choose more than one

Which era would you like the
entertainer(s) to perform?

How long would you like the performance?

Will there be:

 DJ  or  Band or  Neither

Would you like assistance in
selecting a band?

 Yes    No thanks

If you have a budget please specify:

  

How many people do you
anticipate will attend?

  

Would you like the entertainers
 to give out scarves?

 Yes   No  

What is the location of the event?

   Same address as above

If different from address above:

  

Street Address

City

State

Country

Phone number at the location

  

Is there a dressing room available for the performer?

Yes       No

Would you prefer we contacted you by email
     or telephone regarding your request? 

Email    Telephone

Comments: 

  
   

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