Please tell us about yourself or your project    (all applicants must complete this section)

     (Please make your selection from the drop-down menu below)

   Actor/Entertainer Singing Artist Film/TV producer Film/TV Studio or Distributor A&R/Record Label NonProfit Organization        Other:

   Your Name:  

   Your Company (if none state none): 

   Your E-mail:

   Web site URL:

   Phone Number:   Fax Number:  

   In what market do you reside: (city or local)

   When will services be needed?   From:   To:

   ACTOR, ENTERTAINER, SINGING ARTIST:

   Please tell us briefly about your work:

   Do you have an agent?   Yes   No

   Agent or Agency name (if none state none): 

   If you are recording artist, do you have a label?  Yes   No

   Label name:

   FILM OR TELEVISION PROJECTS:

   (Film or Television) Is this an Independent Production?  Yes   No

   Your position on this project: (Please  select from this drop-down menu) UPM/Line Producer Executive Producer Producer Screenwriter/Director Distributor Actor

   Working title or subject of film or TV project? 

   Production Company:

   Has this project been funded?   Yes   No

   Is this project pre-sold / distributor in-place?  Yes   No

   Distribution Company:

   (please check services that best describe your needs)

   Unit Publicity  TV Series Publicist  Event/Appearance Publicity   Premiere Publicity

   Media Junket   Press Conference   Event Promo/Marktg  Personal Publicity

   Other:  

   On what date are publicity services required?    

   For how many days will you require our services?  

   Are you budgeted for publicity?  Yes  No  

   Do you wish us to contact you immediately?     Yes      No

   What is the best way to reach you?   Phone    E-mail.

   Please tell us briefly about your project (you may insert a brief synopsis):