Public Service Event Booking Request Form

Public Service Event

Booking Request Form
* PLEASE COMPLETE THIS FORM IN ITS ENTIRETY IN ORDER FOR SOUTH SIDE STEPPERS, ATL TO ACCURATELY COORDINATE ATTENDANCE OR PARTICIPATION IN YOUR EVENT. PLEASE SUBMIT THE FORM AT LEAST 1 MONTH PRIOR TO YOUR EVENT.
Date Request Submitted

MonthDayYear
Date
Name of Organization*
Organization Website
Contact Information*

First NameLast Name
*
Phone Number
Email Address
Name of Event and Brief Description*
MonthDayYear
Date of Event
Time of Event AM/PM Option
Location of Event*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What type of Service are you Requesting?*

Showcase Line Dances (about 10 minutes)Teach Line Dances (minimum of 15 minutes)Showcase and Teach Line Dances (minimum of 25 minutes)
How Much Time is Allotted for the Requested Service?

30 minutes or less30 minutes - 1 hour1 - 2 hours
*DONATIONS ARE WARMLY RECEIVED AND MUCH APPRECIATED. THANK YOU FOR YOUR SUPPORT.
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