Coffee For a Cause - April 14th, at 6:45pm

Performance Application

Performer Information

How many performers are in your act?

First NameLast NamePhone NumberGrade Level
Main Performer
Performer 2
Performer 3
Performer 4
Performer 5
Performer 6
Performer 7
Performer 8

*Note: All main performer information is required.
*Note: Only numbers can be entered for Grade Level

E-mail Address of Main Contact:

Address of Main Contact:

Performance Details

Original Author/Artist:

If you are doing a musical act, please indicate the type of music:

What type of performance will it be? (***Dance acts must be approved by Mr. Simon)

About how long is your act (in minutes):

There will be 2 halves with intermission between them. Note which half, and what part of the half you want to be in.

List any props or equipment you will need and indicate if you are bringing it yourself. If you don't need anything write none:

Brief description of act and special requests:

Are you bringing back-up music (no vocals)? Note: This needs to be submitted to Mr. Simon no later than April 11th, 2018 preferably in mp3 format via email to or on a usb flash drive. We can also accept an audio CD.
Yes No

Are you bringing drums?
Yes No

Type of instruments.
Acoustic Electric

I/We will donate at least one dozen baked goods per performer on the day of the performance.
All applications are due by Wednesday, April 11 at 11:59pm. Applications submitted before the dealine will received priority. We reserve the right to refuse acts. All performers must be at the library by 6:15pm on April 14, 2018.