Shire of Coolgardie - Expression of Interest Form - Entertainment

By completing this survey, you are consenting to the Shire of Coolgardie saving your contact details. The Shire may contact you regarding community performance opportunities.

Question Title

* 1. Please complete the below contact information

Name *

Company

Address

Address 2

City

State

Postal Code

Email Address *

Phone Number *

Question Title

* 2. What type of entertainer are you?

Music - solo artist

Music - band

Dance

Comedy

Magician

Street performer

Other (please specify)

Question Title

* 3. Please provide URLs to the below profiles (if applicable)

Facebook

Instagram

YouTube

SoundCloud

Website

Other