Request Form

Request Form

Please complete the following Service Request form so that we may better serve your needs.

Contact Information

	Name:
	Email:
	Chapter City:
	Phone Number:
	Title:

Please list the talent your Chapter is requesting:

Choice 1
Choice 2
Choice 3

	Yes, please send me updates and news about your services.

Event Information

Name of Event/Type:
Date of Event:
Artist Responsibility:
Length of time:
Location/Address:

Briefly describe the event:

By completing this form you have authorized the 100 Entertainment International to open and begin negotiations for the talent requested above on your behalf. You understand that any changes to this above form must be made in writing. Please submit this form via the submit button or fax to (951) 848-0671 in request to expedite.

Thank You,
The Staff of the 100 Entertainment International
info@100entertainment.com