First Name
Last Name
Title
Organization
Work Phone
Cell Phone
E-mail

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Corporate Event  Theme Park Event  Fair  College or University  High School  Comedy or Night Club  Casino  Special Event  Private  Seminar  Speaking Engagement  Other Type Not Listed 

Web  Magazine Ad  Surfing the Internet  YouTube  FaceBook  Word of Mouth  Hired Szeles in the Past  Seen Szeles perform  From a Past Client  Search Engine 

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Location of event (very important)

City:

State:

Country if other than United States:

What kind of show would you like:

G-Rated politically correct  PG-Rated a little spicy  R-Rated some sexual routines 

G – Very clean. Suitable for family or conservative groups. No strong language and little or no sexual dialogue or situations.

PG – Mild, adult-oriented subject matter and/or language used in moderation or infrequently.

R – Mature adult subject matter and/or language used liberally. Night-club appropriate.

General Information:

Have you ever hired a Stage Hypnotist in the past?

Yes  No

Are you a entertainment agency?

Yes  No

Additional information or questions

*(Optional) Did the flying monkeys in the Wizard of Oz scare you?

Yes  No

If you make any errors, click the reset button. The entire form will be cleared, simply re-enter the corrected information.  When you are satisfied, click the submit button to send the booking inquiry to SZELES.

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SZELES Stage Hypnotist ©1995-2010 Rainmaker Productions. August 31 2010.

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