| Name of Charity: |
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| First Name: |
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| Last Name: |
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| Address Street |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Daytime Phone: |
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| Evening Phone: |
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| Email: |
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| Web Address: |
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| Mission: |
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| Tax-Exempt Status: |
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| Check One: |
Local |
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Regional |
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National |
| Type of Non-Profit: |
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| URL for Logo or Photograph: |
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| Name of Event: |
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| Address of Event (if known): |
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| Type of Venue: |
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| Date(s) of Proposed Event: |
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| Type of Musician Desired:: |
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| Type of Music Desired: |
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| Required Dress for Event: |
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| Desired Dress for Musicians: |
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Are you willing to pay reasonable and negotiated expenses of musician(s) who volunteer for your event, when applicable? |
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Should interested musicians contact you directly? |
| Name of Contact for Event: |
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| Phone Number: |
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| E-Mail Address: |
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