If you have difficulty with your submission or have questions, email email@example.com Name of Group or Individual Performing:*Number of People in Act:*Names of People in Act:*NameOver 18? (Yes/No) Main Contact:* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 to your YouTube Video*High resolution photo for use by CCEH in Talent Show promotional materialsAccepted file types: jpg, jpeg, gif, png.Ideal photo is of artist performing. By submitting a photo you give permission for its useName 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. This iframe contains the logic required to handle Ajax powered Gravity Forms.