Name:

Phone:

E-mail:

Event Date: Select Month January February March April May June July August September October November December Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2011 2012 2013 2014 or...

Beginning Time for Band:  Hour 12 Noon 1 p.m. 2 p.m. 3 p.m. 4 p.m. 5 p.m. 6 p.m. 7 p.m. 8 p.m. 9 p.m. 10 p.m. 11 p.m. 12 Midnight 1 a.m. 2 a.m. 3 a.m. 4 a.m. 5 a.m. 6 a.m. 7 a.m. 8 a.m. 9 a.m. 10 a.m. 11 a.m. 00 15 30 45

Ending Time for Band:      Hour 12 Noon 1 p.m. 2 p.m. 3 p.m. 4 p.m. 5 p.m. 6 p.m. 7 p.m. 8 p.m. 9 p.m. 10 p.m. 11 p.m. 12 Midnight 1 a.m. 2 a.m. 3 a.m. 4 a.m. 5 a.m. 6 a.m. 7 a.m. 8 a.m. 9 a.m. 10 a.m. 11 a.m. 00 15 30 45

Event City/State:

Event Venue:

Event Type: Select from Drop-Down Options Personal Private Party Wedding Festival Night Club Corporate Function Fund-Raiser Public Event Other (explain in Special Requests)

Attendance: Select from Drop-Down Options Fewer than 50 50-100 100-200 200-500 500-1,000 More than 1,000

Special Requests (for songs such as the First Dance or dinner music, dress, emcee-ing, set-up times, etc.):

How did you hear about The Reunion Band?: Select from Drop Down Options I've been at a live Reunion event. Someone suggested the band to me. I found the band on the internet.