WERC Talenthon Performer

WORLD EMERGENCY RESPONSE TALENTHON PERFORMER

APPLICATION FORM

1. Registration Date *

Date

Time

2. Name *

First

Last

3. Email *

4. Phone Number *

5. Are you a student? *

No
Yes

6. School Name (Enter N/A if you are not a student) *

7. Are you under 18 years old? (If YES you require parent consent?) *

No
Yes

8. I am a parent of the above name minor and I give my consent *

No
Yes

9. Parent Name* *

First

Last

10. I consent to using my child's image, video, and name in WEN's media materials *

No
Yes

11. Parent Signature *

Clear Signature

Consent: By checking this field, you acknowledge that you have read and understand this agreement and agree to the terms therein.

12. What Talent Are You Performing? *

13. Do you think connectivity issues might hinder you from performing live? *

No
Yes

14. Upload File or Video (If this option does not work for you send video to WhatsApp 571-295-2359

Click or drag a file to this area to upload.

15. I consent to using my image, video, and name in WEN's media materials *

No
Yes

16. Performer's Signature *

Clear Signature

Consent: By checking this field, you acknowledge that you have read and understand this agreement and agree to the terms therein.

17. Short Bio *

Share a little information about yourself.

About Us

World Ebony Network (WEN) is dedicated to reinforcing the enduring and noble philosophies, principles, practices (3Ps) of our fore fathers and appreciating the good aspects of other heritages. Our mission helps us to achieve our 3 part vision: to plead the socio-economic causes of people of African ancestry; to reconcile the estrange cultural relationships of people of African ancestry; and to appreciate the good aspects of other heritages.

Resource Links

Contact Support Team
Membership Application Form
Volunteer Assignment Form
Non-Disclosure Agreement
Start A Chapter
Family & Community Support

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Email Address *

First Name

Last Name