Your Name (required)

Your Email (required)

Phone number

Organization name (required)

City (required)

State (required)

Organization mission

Number of local members

Are you willing to help market show to your community/membership?

Yes No 

If yes, how?

Would you like to sponsor the show as a fundraiser for your organization?

(several options available, such as splitting ticket sales proceeds or us donating a percentage of ticket sales)

Yes No 

Would you like to sell your merchandise/hand out info at the show?

Yes No 

Would you like to put on a panel discussion, lecture, Q&A, or workshop with Thea for your members and/or community?

Yes No 

Are you human? If so, enter this:

into this field: