House Concert Application

Name *

First Name

Last Name

Phone *

(###)

###

####

Dates that work for you *

Select all that apply,

January 30

January 31

February 1

February 2

OTHER (please specify in "Message" section below)

Performance Fee

I can meet the $1,000 minimum requirement (Patty solo performance)

I can meet the $3,000 minimum requirement (full band performance)