EmailMe Form - Artist Request Form

CONTACT
Name *
First Last
Country *
Event City (or nearest) *
Email *
Mobile *
EVENT DETAILS
Name of Event *
Date of Event
DD / MM / YYYY
Venue Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Web Site
Facebook Page/Event
Type of Event
Event Capacity
Ticket Price
ARTIST REQUEST
Please choose from the following options to book Aphid Artists or DJs.
Live Act
Aphid Moon
Psibindi
AMD
Dj
Psibindi
Jules Hamer
Kaptain Kairos
Bahar
Psynthetic
Associated Artist
If you wish to book an associated artist we may be able to assist with the booking of the artists in the drop down.
Offers/
Additional Comments
Image Verification

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