Today's Date: *
Contact Information
Contact Name: *
Position: *
Email Address: *
Contact Phone Number: *
Venue Information
Venue Name: *
Venue Street Address:*
City: *
State: *
Zip Code: *
Venue Phone Number: *
If applicable, please indicate the School District:
Performance Space:*
Do you receive Title 1 funding?*
Do you have a tuned piano?*
Production Information
Which production would you like?*
What is your first choice of date? (M-W-F only) *
Please indicate a preferred start time for this date (allow 60 mins for each performance).*
What is your second choice of date? (M-W-F only) *
Please indicate a preferred start time for this date (allow 60 mins for each performance). *
Please estimate the size of your audience (max 300 per performance).*
Payment Information
How many performances would you like to book?*
Payment Method:*
**An HGOco representative will call you to confirm the details of your order before processing a credit card payment.
Signature
The parties to this document intend and agree to conduct the transaction evidenced by this record or agreement by electronic means pursuant to the Uniform Electronic Transactions Act.
Notes/Special requests
