Concerts and Dances Form

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our new facility video!

	General Information
*Last name
*First name
*Address
*City	*State
*County	*Zip
*Office #
Cell #
*School name or organization
Contact time
*E-mail
	Event Information
Type of event
Date of event
Duration of event
# Attending
# Chairs & tables
Equipment required	Pipes and drapes Skirted tables Booth accessories Electrical connection(s) Audio/video displays Stages and platforms Podiums and microphones Other (please describe below)
Beverages
Catering service
Entertainment	Disc Jockey Master of ceremony (MC) Dancers Band Orchestra Other (please describe below)
	Payment Information
Payment method	Personal checks not accepted.
Type of Card
Exp. Date
Card #
	*Type name as it appears on card
First name. .
Last name. .
Middle initial. .
	Billing Address
Address. .
City. .
State .
Zip .
	Other Information
Comments .

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We Will be contacting you within 24 hours.

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