(706) 829-8789

Statesboro, GA

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IMPAKK Performance Request Form

Please fill out the request as soon as possible. Because of high demand, we accept requests on a first-come, first-serve basis. If you have any questions, please don't hesitate to contact us.

Contact Info

Phone: 706-829-8789

Email: impakk20@gmail.com

Social Media

First Name

Last Name

Date of Request

Email

Code

Phone

Address

City, State Zip

Company/Organization

Point of Contact(if other than requestor)

Position

Email

Phone

Performance Info

Is this a fund raising event

Is this event open to the public

Event Title

Ensemble/Service Requested

Is this a political event

Is there a fee or admission charge

Event Date

Event Time

How long is the event?

Preferred Genres of Music

Jazz

R&B/Neo Soul

Oldies

Pop/Rock

Hip Hop

Gospel

Latin

Purpose of Performance

Estimated Audience Size

VIP or Special Guest:

Event Site

Are other musicians/artist performing?

Venue Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Rain Site Location (if Needed):

Amenities

Group Meals

Electricity Available

Sound Provided

Local Trasportation

Message/Special Request

Thanks for submitting!

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