Registration Form for Organizations
Name of Organization
Description of Organization
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name and Title
Contact Phone Number
*
Format: (000) 000-0000.
Contact E-mail
example@example.com
Appropriate Music Genres (click all that apply)
Oldies (Rock n Roll)
Standards/Great American Songbook)
Folk/Americana/Bluegrass
Jazz/Dixieland
Rock
Country
Classical
World (Irish, Klezmer, Polish, Italian, etc)
Holiday
Other
Remuneration Options (click all that apply)
Pro bono (free)
Expenses only
Reduced Rate
Other
Performance Venue Variables (click all that apply)
large social hall or auditorium
small room or reception area
individual patient or resident rooms
outdoors
indoors
In-House PA System (click all that apply)
have full PA system (mixer and speakers)
have oher amplfication
have music stands
have mics
have flatbed dolly
Other
Performance Times/Days
weekday days
weekday evenings
weekend days
weekednd eveings
Other
Please Add any Additional Comments
Upload An Image or Two (Optional)
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