Booking Agency Update Form Order Number Agency Name * Physical Address Line 1: * Physical Address Line 2: Physical Address City: * Physical Address State: – Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Physical Address Zipcode: Physical Address Country: * Mailing Address Line 1: * Mailing Address Line 2: Mailing Address City: * Mailing Address State: – Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Mailing Address Zipcode: Mailing Address Country: * Business Phone: * Business Fax: Company Email Address: * Website: * Agent Roster: Please list each agent, including name, direct phone number and title. Agent (1) * Agent (2) Agents (3) Agent (4) Agent (5) Direct Phone Direct Phone Direct Phone Direct Phone Direct Phone Title Title Title Title Title Email * Email Email Email Email Attach additional agent listings. Also list Assistants to Agents. Artist Roster: Artists on the roster must be nationally touring acts. Acts which do not currently exist in our database will need to show documentation of status (i.e. itinerary showing national dates and record label). Check the Exclusive box if you represent the artist exclusively and include the territory. All listings are subject to confirmation by management. Artist (1) * Territory * Current Label exclusive1 Exclusive Management Company Country Of Origin Management Phone Number Artist (2) Territory Current Label exclusive2 Exclusive Management Company Country Of Origin Management Phone Number Artist (3) Territory Current Label exclusive3 Exclusive Management Company Country Of Origin Management Phone Number Artist (4) Territory Current Label exclusive4 Exclusive Management Company Country Of Origin Management Phone Number Artist (5) Territory Current Label exclusive5 Exclusive Management Company Country Of Origin Management Phone Number Attach additional artist listings. Are you interested in advertising opportunities? * Yes No Please send advertising information and rate card to: Verified By: * Date: *
