EmailMe Form - CALIFORNIA SEMS Booking / Estimate Form

Your Name *

First Last

Your Title /Position *

Your Direct Phone *

### - ### - ####

best number to reach you at

Emergency Contact number

### - ### - ####

When a emergency takes place who do you
want notified.

Emergency Contact Name

Your Email

Production or Company Name:

Production or Company
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Company Phone

Company Fax

Job Name / Number

PO Number

Billing Choices

Check avaiable (total due at end of event / venue)

Cash (total due at end of event / venue

Credit Card

Pay Pal

On Payroll

All invoices are Net 30 unless otherwise stated on invoice

Start Date

Finish Date

Number of Days Total

First Day Call Time *

Example ( 9 AM )

First Day End Time *

Example ( 7 PM )

What is the daily duration of the event

Address of Location of Production/Event or Venue

Street Address City State / Province / Region Postal / Zip Code Country / Region

Location/ Special Instructions/ Stage / Floor

Special Considerations / working invironment

Any Stunt Work / Pyrotechnics / SFX?

Yes

No

*IMPORTANT*
How many at the event / venue total *

Will a security company be on site? *

Yes

No

Security Company Name (If known)

Contact Number or Email for
Security Company

Will the fire department be on site *

Yes

No

Any Working Animals, Type / Size / How Many?

Further Information to be aware of

Please Tell Us How You Found Us. *

Please be as detailed as possible, thanks.