Your Name:

Your E-Mail Address:

Phone number where we can call you (day):

Alternative Phone number  (evening or cell):

Your School and/or Location:

Describe your venue (Classroom/Assembly, Number of Students per Event, Number of Performances/Events)

 :

Additional Comments

: 

Please select  when you would want the artist-

First Choice

Select Date:  0 "3/7/2011" "3/8/2011" "3/9/2011" "3/10/2011" "3/11/2011" "3/14/2011" "3/15/2011" "3/16/2011" "3/17/2011" "3/18/2011" "3/19/2011" "3/20/2011" "3/21/2011" "3/22/2011" "3/23/2011" "3/24/2011" "3/25/2011"   

Select time period:  0 "All Day" "Morning" "Afternoon"            Are you able to provide lunch?:  0 "Yes" "No"                  

Write in Performance/Class times :

Second Choice

Select Date:  0 "3/7/2011" "3/8/2011" "3/9/2011" "3/10/2011" "3/11/2011" "3/14/2011" "3/15/2011" "3/16/2011" "3/17/2011" "3/18/2011" "3/19/2011" "3/20/2011" "3/21/2011" "3/22/2011" "3/23/2011" "3/24/2011" "3/25/2011"   

Select time period:  0 "All Day" "Morning" "Afternoon"            Are you able to provide lunch?:  0 "Yes" "No"       

Write in Performance/Class times :

Third Choice

Select Date:  0 "3/7/2011" "3/8/2011" "3/9/2011" "3/10/2011" "3/11/2011" "3/14/2011" "3/15/2011" "3/16/2011" "3/17/2011" "3/18/2011" "3/19/2011" "3/20/2011" "3/21/2011" "3/22/2011" "3/23/2011" "3/24/2011" "3/25/2011"   

Select time period:  0 "All Day" "Morning" "Afternoon"            Are you able to provide lunch?:  0 "Yes" "No"                  

Write in Performance/Class times :