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Request Clinic Support
(To be considered for assistance, this form must be received at least 60 days prior to event!)
 
Artist*:
Event*:
Event Location*:
Venue Capacity:
Date of Event (mm/dd/yyyy)*:
Street:
City:
State:
Zip Code:
Country:
Estimated attendance :
Percussionists in department :
Percussionists from other locations :
General audience :
Contact Person*:
School Name:
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Fax:
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Artist fee:
Travel:
Lodging:
Food:
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Host contribution:
Other contributions:
Amount requested from Malletech:
Is there a Malletech instrument on site or nearby for the artist to use?:  
 
 
*To be considered for assistance, this form must be received at least 60 days prior to event