Performers Guide Sign-Up Form
Name of Band/Performer:
Name(s) of Performer(s) - 27 words maximum:
The Set (describe performances - 36 words or less):
Booking (contact person & phone no; maximum 6 words, including phone no.):
Website (URL): CATEGORY: Yeah, we know you hate to put a label on what you do, but you gotta check one anyway: Acoustic/Folk Blues Classical Country Country Rock Dance Disc Jockeys Jazz Karaoke Magic Popular Punk Rap/ Hip Hop Rhythm & Blues Rockabilly Rock/Alternative Rock/Classic Rock/Heavy & Metal Rock/Oldies Rock/Original Rock/Southern Standards Tributes Other (2 words max)
Contact Person:
Billing Address:
City/State/Zip:
Daytime Phone:
Evening Phone:
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) 691-3048 CREDIT CARD PAYMENT (MASTERCARD OR VISA)
Name of Cardholder:
Card Number:
Expiration Date:
Three Digit Verification Code (found on right side of signature line on your card):
