Musicians Finder Program Sign-Up Form


Your Name:

Your E-mail Address: (In case we need to contact you)

Name of Band/Performer:

Type of Music:

Other:

Web Address: 2nd Web Address:

Name of Booking Contact: Booking Phone No.:

Email Address for Booking:

Name(s) of Each Performer & Instrument(s) Played

If more than 8, use comments space below:

Performer 1:

Instrument(s):

Performer 2:

Instrument(s):

Performer 3:

Instrument(s):

Performer 4:

Instrument(s):

Performer 5:

Instrument(s):

Performer 6:

Instrument(s):

Performer 7:

Instrument(s):

Performer 8:

Instrument(s):


Describe your set (describe performances - 36 words or less):

Additional Comments (any information that might help us:

Payment Option:

Monthly invoices include an option to switch to annual billing.

Billing Address (Required):

City: State: Zip:

Billing is at time of publication, payable by the 15th of the subsequent month. Payments made within 15 days of the invoice date receive a 5% discount, provided account is paid in full. You may cancel at any time, providedyou agree to pay the difference between the rate you paid and the rate you qualified for on all listings published prior to cancellation. Cancellations must be in writing.Copy changes due by 5 p.m. the first Thursday of each month.

E-MAIL IS NOT A SECURE METHOD FOR CREDIT CARD INFORMATION.
SUBMIT AT OWN RISK, PRINT AND MAIL BOTTOM PORTION, OR CALL (260) 424-4200


Visa Mastercard

Provide credit card information below:

Name (as it appears on card):

Card Number: --- Expiration Date: /

Three Digit Verification Code (found on right side of signature line on your card):

If you wish to pay by cash or do not want to submit credit card information via the web,

you may print out this completed form and deliver (9-5 weekdays) or mail to:

whatzup, 1747 St. Marys Ave., Fort Wayne, IN 46808

Telephone 260-424-4200 during office hours (9-5 weekdays)