Name

Phone Number

Address:

Email Address

Audition Time - Choose One: Audition Time - Choose One:June 28th - 6:00pm @ CCP - 719 Wicker, JC, MO 65109

1st Audition Character Choice: 1st Audition Character Choice:Claude (& others)Bonnie (& others)Beulah (& others)Oz (& others)Janice (& others)Beverley/Annette (& others)Diane (& others)Nick/Doug (& others)Kevin T/Garth (& others)Kevin J/Ali (& others)Hannah (& others)Bob (& others)

2nd Audition Character Choice: 2nd Audition Character Choice:Claude (& others)Bonnie (& others)Beulah (& others)Oz (& others)Janice (& others)Beverley/Annette (& others)Diane (& others)Nick/Doug (& others)Kevin T/Garth (& others)Kevin J/Ali (& others)Hannah (& others)Bob (& others)

Gender: Gender:FemaleMale

Age:

I Will Be Sending In A Video Audition: I Will Be Sending In A Video Audition:YesNo