Jessica Dusk Submission Form

Jessica Dusk Booking Form
Name*

First NameLast Name
Birthday*

MonthDayYear
You MUST be at least 18 years old to be tattooed at our shop.
Phone Number (this is what we'll use to call you for booking!)*
Confirm your phone number*
Please enter a valid phone number.
Please ensure that your phone number is correct. We will not reach out through another method to schedule you. If your phone number does not work, your submission will be forfeited.

When we begin calling submissions, we keep track of when we call you. After two failed attempts/two voicemails without a response, your submission will be forfeited.
Email*
example@example.com
Where are you traveling from?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Will you be using a gift card?*

YesNo
Please provide a detailed description of the tattoo you're interested in getting. The more details you can provide, the better!*
For example: I would like a butterfly in an American Traditional style, with color. I really like monarch butterflies. If possible, we can include my kid's name, "Charlie" placed underneath the butterfly in cursive.
If you would like words in the tattoo, what are the words?
Please upload reference pictures for your tattoo. This can be screenshots from Google/Pinterest, a hand drawn sketch, etc. *

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What tattoo style are you interested in for your piece?*

ColorBlack and GrayLettering/QuoteWatercolorOne of Jessica's posted flashOther
Size of tattoo? (in inches)*
Placement of tattoo? (where on the body)*
Which side of the body? (right, left, center, mirrored, etc.)*
Please upload a clear, well-lit picture of the area you're looking to have tattooed.*

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Is this your first tattoo?*

Yes! We're happy to work with you on your first tattoo.No! You know what to expect.Other
Anything else you would like us to know?*
REMINDER that this form is only to submit for JESSICA DUSK's books. Any submissions for another artist will be disregarded and not saved for future bookings.
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Jessica Dusk Booking Form