Musical Service Request Form Please enable JavaScript in your browser to complete this form.Your Name *FirstLastName of Your Company / OrganizationYour Role at Your Company / OrganizationYour Email *EmailConfirm EmailYour invoice will be sent to you via email. Providing us your email does NOT add you to any emailing list.Your Phone Number (please enter without dashes) *Scheduling your musical service happens over a free phone consultation. Please provide the number where we can best reach you.Are you looking for a one-time musical service or a package of musical services?One-time musical servicePackage of musical servicesAre you requesting music to honor an individual or a group of people?I am requesting music to honor an individual.I am requesting music to honor a group of people.If the musical service you're requesting is for an individual other than yourself, please provide the first and last name of the person we are honoring.FirstLastWhat kind of musical service are you requesting? *Funeral / Memorial Music (at funeral homes, churches, et al.)Palliative Care Music (at assisted living, hospice care, nursing home, et al.)In-Home Music (at the recipient's residence, whether in person or virtual)Do you want the music provided in person or remotely via phone or video call? *I want music provided in person. I want music provided remotely via phone or a video call.If you wish to receive musical services in person, what is the name and address of the location where the performance will be held?When do you want this musical service provided? Please check all that apply. *ASAPWithin 7-14 days from todayWithin 14-21 days from todayWithin 1 month from todayThe preferred date is more than a month away.The preferred date is a special occasion (i.e. birthday, holiday, etc.).No preferenceOther (please explain in comments section)What time of day do you want the music performed? Our performances are scheduled in Eastern Standard Time (EST).Morning (9am - 11:59am EST)Afternoon (12pm - 4:59pm EST)Evening (5pm - 8pm EST)What genre(s) of music do you want performed? *BluesChristian / GospelClassicalCountryInstrumentalJazzMusical TheatreOperaOther (please tell us what you'd like in the comments section)PopRockIf you have particular songs or artists in mind you would like us to perform, please make a list here.Discount codes, questions, comments, and additional information you think we should know about your request may be added in the space below. We will contact you regarding your request within 6 business hours. Thank you!Submit
