Artist Profile Form

List and number all instruments used in performance.  For electric instruments - please indicate the name/model amplifier and type of direct outputs (if equipped) (1/4' or XLR).
Example:

• Instrument #1: Guitar 1 (acoustic w 1/4" pickup))
• Instrument #2: Guitar 2 (acoustic w/ pedal 1/4 " )
• Instrument #3: Mandolin (acoustic to be mic'd)

Please List all song titles to be performed (ie. Title #1, Title #2 etc.).  Indicate if the song is orginal music or public domain music.  If orginal please list the following:
Title #1

• Date of Copyright or First Publication
• Publisher Information (Name, Address & Phone of Publisher)
• Name of Copyright Claimant (please indicate words, music or words & music)