Talent Show Application – Concord Coalition to End Homelessness

Name of Group or Individual Performing:*
Number of People in Act:*
Names of People in Act:*
Name Over 18? (Yes/No)
Main Contact:*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Talent Category (Choose One)*
- Music
- Comedy
- Dance
- Magic
- Poetry / Spoken Word
- Theater
- Acrobatics / Gymanastics
- Other
If "Other" Please Describe Your Act*
Name of Piece to be Performed:*
If performing original music, when was it developed, with who, and where?*
Insert Link for your Facebook or YouTube Video*
Name of Person submitting application:*
Email*
I/We wish to enter the Concord Coalition to End Homelessness Talent Show and by submitting this application I agree to abide by the rules.*
- I agree.

Name	Over 18? (Yes/No)