Marc Burgess Productions
Information Request Form
Date Of Event
First Name
Last Name
Organization/Fiance
Email Address
Mailing Address
Address Line 2
City *
State *
Zipcode *
Telephone
Best Time To Reach You
Guest Count
Start Time
End Time
Event Location (venue)

If your event location is not listed above please fill in the following...


Event Location (Venue)
Event Location (City)
Event Location (State)
Type Of Event
Additional Questions Or Event Details
How did you hear about us?
How important is the entertainment to the success of your event?
How soon will you be booking your entertainment?