What is your legal first name?
What is your legal last name?
Name as you want it to appear in the program?
Preferred Name?
What are your pronouns? (optional)
Mailing Address:
(Where we would send your tax information)
Street
City
State
ZIP
Best phone number to contact you?
Best email to contact you?
What is the best way to get ahold of you?
TextPhoneEmail
What is your role in the company?
Actor (AEA Member)Actor (Intern; Non-Equity)ChorographerDesignerDirectorPlaywrightTechnical InternStudent: Acting ConservatoryStudent: Tech ConservatoryOther
Do you have a Social Security number?
YesNo
Do you have a valid US Driver’s License?
How are you traveling to Santa Maria?
AirAutoI am a local hireOther
What city are you flying out of?
What is your Date of Birth?
(for ticket booking purposes)
Window or Aisle Seat?
WindowAisle
If you have a frequent flyer number, please include the number and airline name here. (optional)
Number and Airline Name
License Plate
State Issue
Year
Make
Model
Color
Other
Allergies/Medical Information (optional)
