Name of applicant organization: |
|
Address: |
|
Telephone: |
|
Fax: |
|
*E-mail: |
|
Webpage: |
|
| |
Name of legally responsible officer representing applicant who will execute lease contract: |
Name: |
|
Title: |
|
Address: |
|
Telephone: |
|
Fax: |
|
E-mail: |
|
| |
Dates and times requested for use of the theater (please specify load in, rehearsals, performances, strike): |
|
Alternative dates: |
|
Title & type of presentation (theater, lecture, opera, ballet, concert, etc. Please list featured artists, speakers, etc.): |
|
Expected length of event (including intermission): |
|
Admission to be charged:
|
How will proceeds be used? |
|
Beneficiary organization, if other than applicant (tax-exempt religious, charitable, or educational): |
|
| |
|
Date and place founded: |
|
Purpose of organization: |
|
Artistic director or managing director: |
|
|
Attach evidence of federal tax-exempt status of applicant and beneficiary organization, if different. |
|
|
1. Applicant’s bank/branch: |
Address: |
|
Phone number: |
|
2. Personal references: |
* Name: |
|
* Phone number: |
|
Security code |
|
* Insert the security code |
|
|
* Required Fields.
|
