Southern Fried Circus Fest Application
Solo, Duo or Group Act *
Stage Name (if applicable)
First Name *
Last Name *
First Name (Partner or Group Name, if applicable)
Last Name Name (Partner, if applicable)
Birth Date
MM
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DD
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YYYY
Birth Date (Partner, if applicable)
MM
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DD
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YYYY
Discipline *
If Other, Specify:
Experience Level *
Email *
Phone: *
Address:
Link to Submission Video:
What are you hoping to gain from this experience?
What are your current strengths/weaknesses as a performer?
Is there anything you want the panel to know about your piece?
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