Instagram Takeover Request Form
Please note that submitting a request through this form does not guarantee that you will be contacted for an Instagram Takeover
Name
Your answer
Email Address:
Your answer
Type of Takeover
Describe the content of your takeover
Your answer
Proposed Date (if any)
MM
/
DD
/
YYYY
What's your Instagram handle or Facebook URL so we can get a feel for your social media presence?
Your answer
Before submitting, please keep in mind Burlesque Boston's values and mission: We are dedicated to fostering a culture of inclusion and empowerment within a safe and accountable community.

Thanks for being a part of the Burlesque Boston community!

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.