FAXABLE REQUEST FOR INFORMATION FORM

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

What is the best time of day to contact you? Between __________AM and __________PM (i.e. 8 AM & 5 PM, ET)

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)? $__________, $__________, $__________, $__________, $__________

May we add you to our mailing list?  _____ Yes     _____ No

Additional information, comments or questions :_________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

PRINT PAGE

Share on Facebook Share on TwitterShare on Twitter