Lost Gig Benefits

In order to qualify for lost gig benefits, the applicant must either reside in the Annapolis area or must have gigged in the Annapolis area at least 18 times during a 12-month period from January 1, 2019, to present.

AMFM defines “the Annapolis area” as the following zip codes: 21401, 21402, 21403, 21404, 21405, 21409, 21411, 21412, 21012, 21032, 21035, 21037, 21106 or 21140.

If you qualify, complete the “Lost Gig Benefits Application” and submit it to AMFM.  Applications must be submitted within six months of the date of the lost gig.

Once received, AMFM will review your application and respond to your request.

If you are human, leave this field blank.

LOST GIG BENEFITS APPLICATION

Please note:

(1) For purposes of this application, the “Annapolis area” is defined as the following zip codes: 21401, 21402, 21403, 21404, 21405, 21409, 21411, 21412, 21012, 21032, 21035, 21037, 21106, and 21140. Annapolis-area residents may be asked to provide proof of residency.

(2) Applications must be submitted within six months of the date of the lost gig.

(3) To qualify for reimbursement, the gig’s locations must lie within a 50-mile radius of Annapolis.

(4) If you have any questions about this application, please contact us via email at annapolismusiciansfund@gmail.com.

A. Contact Information

Name *

Address *

CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabwe

City

StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin Islands

Zip code

Phone *

Email *

B. Residency:

Are you an Annapolis-area resident - do you reside in one of the aforementioned zip codes? (You may be asked to submit proof of residency.) *

Yes

No

IF YOU ARE NOT AN ANNAPOLIS-AREA RESIDENT, please list at least 18 dates and venues (plus contact info) where you have performed in the ANNAPOLIS AREA during a 12-month period from Jan. 1, 2019 to present (Annapolis area zip codes at top of this page).

LIST GIGS IN THE BOX BELOW IN THE FOLLOWING FORMAT: DATE, VENUE, VENUE CONTACT, PHONE NUMBER OR EMAIL, AND AMOUNT OF REVENUE LOST. PLEASE LIST ONE GIG PER LINE. EXAMPLE: 4/7/2021, ABC Bar, John Smith, 410-123-4567, jsmith@abcbar.com

C. Band and Gig Information

Name(s) of your band(s): *

Instrument(s) played professionally: *

D. Gigs Lost

Date of 1st Lost Gig *

Venue *

Revenue Lost *

Venue Location *

Band Name *

Venue Contact Name *

Venue Phone *

Date of 2nd Lost Gig

Venue

Revenue Lost

Venue Location

Band Name

Venue Contact Name

Venue Phone

Additional Gigs Lost: PLEASE LIST ADDITIONAL GIGS FOR WHICH YOU ARE SEEKING BENEFITS. PLEASE LIST GIGS IN THE FORMAT SPECIFIED BELOW, ONE GIG TO A LINE:

E. Additional Information:

Please provide the reason for the loss or cancellation of the gig(s) for which you are seeking benefits.

*

F. Certification and Date

Please complete the certification below: *

By checking this box, I certify that all the information provided in this application is true and accurate to the best of my knowledge.

By typing my name below, I am providing a form of electronic signature. *

Date

Please verify that you are a human: *

For security verification, please enter any random two digit number. For example: 91

Submit