Program Interest Form

If you are interested in having Freetown Village provide a program for performance for your organization, please use the form below.

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

PROGRAM TYPE

Freetown Village Singers

Madam Walker Story

Craft/Heritage Workshop

Unsure - please contact to discuss

Program Date & Day of Week - 1st Choice

Program Time (include A.M. or P.M.)

Program Date & Day of Week - 2nd Choice

Program Time (include A.M. or P.M.)

Program Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Other Information