November 20 & 21, 2010
2010 MOWD PERFORMANCE APPLICATION
Performer/Group Name:______________________________________________________
Contact Name:______________________________________________________________
Address:___________________________________________________________________
City:
Phone: (____)__________________________ Email Address:________________________
Please specify your performing art (poet, musician, trick roper, etc.)
_______________________________________________________
List the members of your group and their specialty Instrument/Specialty Act
1.__________________________________________________ ___________________________
2.__________________________________________________ ___________________________
3.__________________________________________________ ___________________________
4.__________________________________________________ ___________________________
5.__________________________________________________ ___________________________
6.__________________________________________________ ___________________________
Dates & times you can perform
Sat.
November 20 10:00-Noon ____ Noon-2:00 pm ______
Sun
November 21 10:00-Noon ____ Noon-2:00 pm ______
Names: (for entry badges- please print clearly)
_________________________________________ _________________________________________
_________________________________________ _________________________________________
_________________________________________ _________________________________________
We must know your availability for scheduling. We hope you will be able to attend both days of the festival.
Please be certain to let us know if you will be available prior to the event for television, radio and/or
newspaper interviews.
Arrival Date: ___________________________ Departure Date: ________________________________
Check the website for more details - www.mesaoldwestdays.com
This event a function of Mesa Old West Days LLC