How did you learn of our agency?

First Name:      Last Name: 

Address:      City/ST/Zip:

E-mail Address: 

Best Number to Reach You:      Alternate Phone: 

Ethnicity: 
Caucasian     African-American     Asian     Pacific Islander     Hispanic/Latino     Native American         
Other:

Car Make, Color, & Year: 

   Ht:    Wt:    Hair:    Eyes:    Chest:     Waist:    Hips: 

Sizes (Be accurate, but give best guess if not sure. This is used for on-set wardrobe sizing considerations):

MALES: 

Shirt (S,M,L, etc):    Neck:    Jacket:    Pants: X   Shoe:     Hat: 

FEMALES:

Blouse (S,M,L, etc.):    Dress:    Pants:    Shoe: 

Describe any previous stage/screen/dance/singing/modeling experience & hobbies:

Days/times are you available to do extra work (or can make yourself available):

I agree to be responsible and trustworthy extras on set of every production I am sent to. By typing my name below and clicking the submit button, I acknowledge understanding of this agreement, and I agree to comply with this policy.

Signature of Extra (Type your name here) 

 I verify that I am 18 years old or older and have filled this form out myself. I verify that I am the parent or guardian of the person that this form is filled out for.
Parent(s) Names: