Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PERSONNEL *

Please check if you are able to provide someone to run these areas.

Sound (Front of house)

Media (Visual)

EQUIPMENT *

Please check any equipment you have available.

Vocal Mic

Speaker Mic

Boom Stand

iPad Stand

Music Stand

INSTRUMENTS

SOUND DESK (MIXER) *

Please advise

Digital

Analogue

Number of channels

MONITORING *

Please check below

Fold-back Speaker (floor monitor)

IEM (In Ear Monitoring)

MEDIA SCREEN *

Please Check Below

Central Screen

Side Screen 1

Side Screen 2

MEDIA PACKAGE *

Please advise if you have a media package that enables you to download and display song lyrics from CCLI

YES

NO