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Personal Information

Name:

Email Address:

Phone Number:

Social Media Links (optional):

Please select the type(s) of event you are interested in:

Spoken Word Events Open Mics Showcases

Brief Description of You:

Have you performed at our events before?

Yes No

Do you need any special accommodations?

Yes (please specify): No

How did you hear about our events?

Social Media Word of Mouth Flyer/Poster Other:

Please indicate your availability for upcoming events (dates/times):

By submitting this application, you acknowledge that all information is accurate and agree to the terms and conditions of our events.

Signature:

Date: