Medallion Talent Show Form
20 Park Street, Gorham, NH 03581
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
Please pick a date for Audition
*
January 28th
February 4th
Cell Number / Text
*
-
Area Code
Phone Number
What Prop/Equipment will you bring
*
Describe your act and the number of people.
*
Where you heard about it (Facebook, Instagram, Google, etc.)
*
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