Salon /Stylist registration form

My Business / Organization's Title:

My Business / Organization's Full Address:

Contact Person's Name / Job Title:

Describe The Entertainment That You Will Provide:

How Many Models will participate  

Theme of your  Segment

√ I understand and agree that the allotted time for my entertainment performance is: 15mins

Beginning @ _____________ and Ending @ _____________________

________________________________________________________________________

My Office Telephone #:________________ Fax #: ___________________________ 

Other #: ________________________________________________________________________

Cell Phone#: ____________________ Pager #: _______________

Email:__________________________________________________________________ 

Please place a check mark on the appropriate line below

______ Yes, I/ we will attend and participate in 4th Annual I Am Not My Hair Show 

______ No, I/ we will not be available to attend 4th Annual I Am Not My Hair Show

Signature: __________________________________ Date: ________________