New Client Intake Form We are excited to be working with you!Please complete the form below so that we can learn more about you and your business. Please write N/A for sections that do not apply. GENERAL INFORMATION Name * First Name Last Name Stage Name (if any) Email * Phone Number * Please send the best number on which to reach you, and for us to correspond with you through text should you choose. Country (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country TALENT REPRESENTATION Talent Agency Agent Name Management Company Manager Name ONLINE PRESENCE Personal Website http:// Instagram Handle Twitter Handle COMPANY INFORMATION (if any) Company Name Company Website http:// Company Twitter and/or Instagram Handles Address Address 1 Address 2 City State/Province Zip/Postal Code Country State/Province/Country of Incorporation Date of Incorporation Text Messaging Please let us know if you would like us to correspond with you by text message from time to time. * Yes No Other Information Please include anything else that could be helpful Thank you!
