Symphonic Relief for Haiti Form
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1. Symphonic Relief For Haiti: Performance Form
Welcome!
Thank you for your support of Haiti and joining the mission of Symphonic Relief for Haiti. Your help brings the international community together with the power of music to support those in need!
We would like to keep track of who is performing where and a few other details to have a record of the extent of this movement. Please take a few minutes to fill out the form below.
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1
. Group Information
Group Information
What is the name of your group?
Please give a brief description of your group (a few words):
Website address (if any):
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2
. Contact Information
Contact Information
Who is the contact person?
Contact Phone Number:
Contact E-mail:
Contact Address Line 1:
Contact Address Line 2:
Contact City and State:
Contact Zip Code:
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3
. Concert Information
Concert Information
Name of Concert:
Date and Time of Concert:
Concert Venue:
Venue Address Line 1:
Venue Address Line 2:
Venue City & State:
Venue Zip Code:
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4
. What organization did you benefit at your concert? (e.g. Partners in Health, Red Cross, Clinton/Bush Fund)
What organization did you benefit at your concert? (e.g. Partners in Health, Red Cross, Clinton/Bush Fund)
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5
. How did you raise funds for Haiti at your event? (e.g. ticket sales to proceeds, raffle, audience appeal, etc.)
How did you raise funds for Haiti at your event? (e.g. ticket sales to proceeds, raffle, audience appeal, etc.)
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. If you have already held your event, how much was raised?
If you have already held your event, how much was raised?
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. In his Nobel Peace Prize acceptance speech, Dr. Albert Schweitzer sent a message to the world, saying "A humanitarian spirit abides within all men like tinder ready to be lit, waiting only for a spark. May the nations, in their efforts to maintain peace, do their utmost to give the spirit time to grow and to act."
What is your message to the world?
In his Nobel Peace Prize acceptance speech, Dr. Albert Schweitzer sent a message to the world, saying "A humanitarian spirit abides within all men like tinder ready to be lit, waiting only for a spark. May the nations, in their efforts to maintain peace, do their utmost to give the spirit time to grow and to act." What is your message to the world?
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