Site Name:
Site Description (School, Nursing Home, etc.):
Address:
City:
State:
Zip:
Site Phone:
-
-
Fax:
-
-
Contact Name:
Contact Phone:
-
-
Email:
Requested Date(s)*:
Times:
Times:
Times:
Performance Space Description:
Equipment Loading Specifications:
Piano: Yes
No
(Check yes or no). If yes, check
Upright
Grand --Date of last tuning
Anticipated audience size:
Reason for Performance:
Please provide a brief description of your goals for a Gluck Fellows performance (i.e., how you feel the music will impact your program; how you expect the music to benefit the audience, etc.)
*Performances may not be used for benefits, fundraisers, or other social functions where the performers are not the primary focus of the audience.
--Please include proof of non-profit status with application.
*While every effort will be made to satisfy your request, not all performance dates/times can be accommodated. You will be updated regarding the status of your request within two weeks of submitting this application.