Bill Riley Talent Search

Online Entry Form

Iowa County Fairgrounds

Entertainment Tent

PERFORMER #1 (If this is a group, performer 1 will be the group contact):

All information required to submit:

First Name:          Last Name:       

Street Address:   

City:            State:  Iowa           Zip:        

Phone Number:     

E-Mail Address:       

Age as of July 16, 2007:    Date of Birth (xx/xx/20xx):    

Type of Talent:

Accompaniment Needed:

        -- No Yes Electric Keyboard     

        -- No Yes Tape Player

        -- No Yes Compact Disc Player

        -- No Yes Other, Please Specify:  

Will this be a solo or group performance?

        -- Solo Group

Additional Information for Groups

(We need information for ALL members of a group)

______________________________________________________________________________

Performer #2 (Please leave blank if not needed)

First Name:          Last Name:       

City:            State:  Iowa   

Age as of July 16, 2007:            

Date of Birth (xx/xx/20xx):            

______________________________________________________________________________

Performer #3

First Name:          Last Name:       

City:                State:  Iowa   

Age as of July 16, 2007:      

Date of Birth (xx/xx/20xx):            

______________________________________________________________________________

Performer #4

First Name:          Last Name:       

City:            State:  Iowa   

Age as of July 16, 2007:       

Date of Birth (xx/xx/20xx):        

______________________________________________________________________________

Performer #5

First Name:          Last Name:       

City:            State:  Iowa   

Age as of July 16, 2007:      

Date of Birth (xx/xx/20xx):           

______________________________________________________________________________

Performer #6

First Name:          Last Name:       

City:            State:  Iowa   

Age as of July 16, 2007:      

Date of Birth (xx/xx/20xx):           

______________________________________________________________________________

Performer #7

First Name:          Last Name:       

City:            State:  Iowa   

Age as of July 16, 2007:      

Date of Birth (xx/xx/20xx):           

Please assure that your contact information is correct before submitting! 

Your application is NOT CONSIDERED SUBMITTED until you receive a confirmation email from the show coordinator.  Please allow 2-3 working days for your confirmation email to arrive.

For additional questions or concerns, please contact Diana Roberts at 319-642-5406 or email: talent@theiowacountyfair.com