THEATRE MAXIMUS
Licensing Agent for GODSPELL
1650 Broadway, Suite 601, New York, New York 10019
(212) 765-5913 Fax: (212) 265-0207
Email
Please clearly print or type information. Thank you.
| Name (Individual/Company/Organization): | _______________________________________________ |
| Contact Person (Company/Organization): | _______________________________________________ |
| Title/Position (Company/Organization): | _______________________________________________ |
| Address - Street: | _______________________________________________ |
| Suite or Building Number: | _______________________________________________ |
| City & State/Province: | _______________________________________________ |
| Zip Code: | _______________________________________________ |
| Telephone (include extension): | _______________________________________________ |
| Fax: | _______________________________________________ |
| E-Mail: | _______________________________________________ |
| Web Site: | _______________________________________________ |
| Billing Address If Different Than Above - Street: | _______________________________________________ |
| Billing Suite or Building Number: | _______________________________________________ |
| Billing City & State/Province: | _______________________________________________ |
| Billing Zip Code: | _______________________________________________ |
| PLEASE CONTACT ME REGARDING: GODSPELL THE MUSICAL | |
|
Please have a representative: _____ Call Me _____ Fax Information _____ Mail Information |
|
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What is the best time of day to contact you? Between __________AM and __________PM (i.e. 8 AM & 5 PM, ET) |
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| Has your group/organization performed Godspell before? _____ Yes _____ No | |
| If Yes, when? ________________________________ | |
| When are your planned run dates for Godspell? From:____________________To:____________________ | |
| How many seats does your performance space have? ___________________ | |
| What is/are your ticket prices(s)? $__________, $__________, $__________, $__________, $__________ | |
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May we add you to our mailing list? _____ Yes _____ No |
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| Additional information, comments or questions :_________________________________________ | |
| ________________________________________________________________________________ | |
| ________________________________________________________________________________ | |
| ________________________________________________________________________________ | |
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