Luther's - The Blues Musician's Road Resource Directory

A Project of
The Luther Allison Endowment Fund
Of the Blues Community Foundation and
Forever Blues Productions©®

 

PARTICIPATION APPLICATION FORM

"We will not sell any personal information gathered from you to any third party for any reason. We will not divulge information in anyway other than the preparation of the LUTHER'S DIRECTORY. (print and online) We and the artists and musicians appreciate your participation and support and we honor your privacy!"

Areas marked by an * are required to be filled in for our purposes
ONLY name, city, contact phone, and help areas will be published.

YES!

 I want to help blues musicians on the road and would like to be listed in LUTHER'S, The Blues Musician's Road Resource Directory.

YES!

 I understand that this is a VOLUNTEER activity to support emergency needs of blues musicians and bands working on the road.

YES!

 I understand this Directory will be distributed to musicians, agents, blues societies, blues clubs and festivals and others who are a point of contact for blues musicians working on the road.

I am not ready to sign-up today, but would like more information. Please contact me!

*Name:

Occupation:

*Address:

*City:

*State:

*Zip Code:

*Home Phone:

*Business Phone:

*Mobile Phone:

*Fax Phone:

*E-Mail Address:

Additional E-Mail Address:

Website Address:


Please check all areas of service that you are willing to give or assist in finding.

Medical Lodging Legal Other
Food Service Auto Mechanic Communications General - I just want to help
My Signature________________________________________
(If printing and sending in, please sign here. If submitting through email type your name in the box below - Thank you!)

Name:

 

  

THANK YOU!
Please complete this form and email, or print - complete and mail to:
Barbara "Toez" Hammerman
C/O Luther Allison Endowment Fund
5114-E Pt. Fosdick Dr. NW, #276, Gig Harbor, WA 98335
or call 1-253-858-4435 for more information.