Midweek Microdose SPECIALTY ACT Submission Form
Fill the form below and we will get back soon to you for more updates and plan your appointment with Dr Mox!
Stage/Perferred Name
*
First Name
Last Name
Act/Group Name (If Different)
Social Handles (Facebook and/or Instagram)
Email
example@example.com
Have you ever applied to be/performed on a #MidweekMicrodose before?
Yes
No
What performance act would you like to share with us? Be creative and descriptive!
Do you have performance experience? Please describe below.
This show is a paid opportunity. Are you willing to follow all show rules, maintain a proper code of conduct and professionalism, and bring positive energy to our space both onstage and off?
Yes
No
The show format offers to two 5-7 minute "sets" of performance. Is this something that is attainable with your act?
Yes
No
Do you have a professional promotional photo we can use for our poster if selected?
Yes
No
Do you have any photo/video of yourself performing?
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