Brief  -  Self Introduction

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

 

Success "ALWAYS"  involves - Great Connectivity

Please identify and describe yourself:

Name & info
Date of Birth
Sex	Male Female

Select any of the following options that apply:

List what "You" do, and "what" you would Like to Present

Are you part of a school or other organization - who would like to perform ?

List equipment you have

QTY	DESCRIPTION

( we do not provide PA or  any performance equipment)

Enter the date you are interested in performing :

-- mm/dd/yy

Youth Groups - Must be Endorsed by an Adult !

List: responsible parties contact info

What is your aspiration ?

Please provide the following information:

Type Act	Group Individual Sports Other
Modeling or Acting
Arts -Craft
Demonstrations
Self Help  Class

   "it could be You"