Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Which location are you looking to book me?
*
Please Select
Charnel House Tattoo (Los Angeles CA)
Dirt Nap Tattoo (Eugene, OR)
Convention / Guest Spot (Must correlate with my travel schedule)
Where will the tattoo be placed?
*
Please Select
Arm
Leg
Back
Torso
Neck
Foot
Head
How large or small would you like the tattoo?
*
Your best guess in inches, if possible
Description of desired tattoo. Be as detailed as possible!
*
Tattoo Inspiration
*
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