Youth Performances Application

Youth performers are needed to provide entertainment at the 4th Annual Bridging the Bay After School Conference on Friday and Saturday, February 1-2, 2013 at Bret Harte Middle School (3700 Coolidge Ave. Oakland, CA). The conference brings together over 500 after school professionals from seven Bay Area counties.

Four performance groups are needed to provide 10-15 minute performances during lunch, each day of the conference. The performers' organization will receive a $100 stipend.

To apply please complete the form below by Friday, December 28.

For more information please contact Zak Parpia at zparpia@calsac.org

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* 1. Contact Name:

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* 2. Title:

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* 3. Organization Name:

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* 4. Web Address:

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* 5. EIN or Social Security Number:

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* 6. Phone Number: Please list the best number to reach you at

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* 7. Email Address:

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* 8. Cell Phone Number:

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* 9. Address:

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* 10. City:

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* 11. State:

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* 12. What is the age range of the performers? Please check all that apply.

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* 13. Please list the name of the organization to receive the $100 stipend - stipend check will be made payable to this organization:

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* 14. What address should the stipend check be sent to, if different from above?

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* 15. Please describe the performance in as much detail as possible (music, dance, number of performers, length, etc.).

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* 16. Please list your AV needs and any other special requirements:

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* 17. Please list any equipment you will bring with you for your performance:

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* 18. Are you able to perform indoors and/or outdoors?

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