INTERNATIONAL MODEL & TALENT SEARCH
Become a Star!
Saturday, November 6, 2009 - 11:00AM – 5:00PM
*Held @ Julie Nation Academy/Model & Talent Management, 2455 Bennett Valley Road Suites 110A, Santa Rosa CA 95404*
Public Registration Fee: $885
Payment Plan Choices:
PLAN A: Paid in full
PLAN B: Monthly Payemnt Plans available (with a one time $20 bookkeeping fee)
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Name (Last)______________________________________
(First)______________________________________
Parent/Guardian (if
participant is under 18)_________________________________________________________________________
Address_______________________________________________
City_______________________________ Zip_______________
Phone Home/Cell _______________________________________________ Age_________
Date of Birth ___________________
Female: Height _______
Bust________ Waist________ Hips________ Hair Color__________ Eye Color__________
Male: Height_________
Jacket Size_________ Hair Color_____________ Eye Color______________
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Registration Fee Includes: Presentation to agents and casting directors, Theatre Rehearsal(s), industry workshops taught by agents and casting directors, agent callback opportunities, follow-up consultation for agent results, free consultation for qualification for Julie Nation Modeling & Career Management services.
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Additional Divisions: ($75.00 each over and above the registration fee, or $50.00 each for group and portfolio divisions)
¨ Modeling: Solo
Fashion Runway _____ Advanced Fashion Runway (troupe) _____
¨ Acting Performance
¨ Dance Performance
¨ Singing Performance
¨ Portfolio Division
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Search Registration ...................................................
| $____________________ |
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Past Participation Discount deduct $100 ...................
| $____________________ |
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Additional Division(s) ________ x $75 .....................
| $____________________ |
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Additional Division(s) ________ x $50 .....................
| $____________________ |
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Total
| $____________________ |
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Payment Enclosed:
$_________________ ¨ Check/Money ¨ Visa ¨ Master Card
Card Number
_____________________________ Exp. Date _______________ Card Security# _______
Cardholder Signature
__________________________________________________________________
Please make checks
payable to “Julie Nation Inc.” and mail form and payment to:
Julie
Nation Academy,
2455 Bennett Valley Rd. Suite 110A, Santa
Rosa, CA 95404
NO REFUNDS AVAILABLE, BUT FEES CAN BE
TRANSFERRED TO THE NEXT SEARCH
PHONE: (707) 575-8585 OR Toll Free (888)793-0177 - Form may be faxed to 707-575-8596
Believe in
Yourself and Live Your Dream!