Historical Entertainment Membership Application

(please note all fields with a * are required)

Personal info:
*First name: Required
*MI : Required
*Last Name: Required
*Salutation (Mr./Mrs. etc.): Required
*Occupation: Required
 
Contact information:
*Contact Name: Required
*Address 1: Required
Address 2:
*City: Required
*State: Please select an item.
*Zip: Required
Please put in a valid, 5-digit ZIP code.
*Country: Required
*Home Telephone: Required
Please enter your number in this format: 555-555-5555
*Work Telephone: Required
Please enter your number in this format: 555-555-5555
*Mobile Telephone: Required
Please enter your number in this format: 555-555-5555
*Email: An email address will be required.
Please put in a valid email address.
 
Characteristics:
*Gender: Please select an item.
*Date of Birth: Please select an item. Please select an item.* Required
Height Please select an item. (feet) Please select an item. (inches)
 
Credits & Experience:
*Film Credits:
Please list film name, production company and your role.		 Required
*Horseback riding skills: Please select an item.
*Stunts: Please select an item.
*Do you have your own uniform(s) and/or civilian clothing? If so, please describe which periods, and types of impression you can cover. Required
*Are there any historical/repro props and set dressing items you can provide for productions? (e.g. tents, wagons, farm implements, tableware, etc) Required
*Hobbies: Required
 
Administrative:
*Username:
 Required
*Password:
(alphanumeric characters only please)		 Required confirm password*
RequiredThe passwords do not match.
Professional acting organizations/union membership:

Minimum number of selections not met.Maximum number of selections exceeded. SAG
Minimum number of selections not met.Maximum number of selections exceeded. AFTRA
Minimum number of selections not met.Maximum number of selections exceeded. Equity
Other memberships:
Required
*Expected base salary for one day (roll call to wrap) Please select an item.
*Distance willing to travel: Please select an item.

*Photos must be provided in .jpg, .gif, .png format and will be converted to .jpg
Photos greater than 800 pixels high or wide will be resized

(please note all fields with a * are required)
Historical Entertainment, LLC
25450 Highfield Road
Cascade, MD 21719 		Phone: (301) 241-4707


Historical Entertainment, LLC is a Limited Liability Company registered in the State of Maryland.