Text Box: Are you a prospective bazookaMODELS client and may need the services of any/some of our models/Actors to promote your company, business or services? Please complete the Client Form below to receive an access password to our database of mostly professional and aspiring talents.

Please fill in the form below to submit your details to us

Client Form

1st Name

Surname

Sex: Male Femele

Nationality

Resident Country

Occupation/Business

Address

Mobilephone

Home phone

Office phone

Fax Number

E-Mail Address

Re-enter E-Mail Address

 

What company are you representing ?

Title/position within the company/business/service

----Title Position Business -Service

What work category do you need the model for [tick as applicable]:

Fashion Print Promotions TV/Video Glamour Hostess/Billboards

What talent type do you seek?

Models Actors

Probable date the Model/Actor's services would be needed:

- - Month, Day, Year

until

- - Month, Day, Year

Choose your Client Username on bazookaMODELS [eg: shakazulu, mogul, etc]

Any other information:

 

 

----------------- I agree on the terms and conditions

 

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