Amputees In Hollywood

A subsidiary of the Amputee Resource Foundation of America, Inc.
www.amputeeresource.org

Talent Inquiry:

Name *
                             First                                   Last
Company or representing *

 *           
                         Street Address                                                  City                           State     ZIP
                  
Telephone *  Fax   E-mail *

Your previous film projects *

Talent you are considering for the role:
Non Specific Ally Amy Autumn Barb Chris Christie Christine Clint Eve George Jon Kurt Lacey Sean Tim Tracy Valerie Vanessa

Brief outline of your project *
 
                                                                       
     * Required fields for a response from Amputees In Hollywood.