APPLICATION FOR CATASTROPHIC BENEFITS

Please Note: In order to qualify for benefits, applicants must fulfill the following qualifications:

1) You must either (a) reside in the Annapolis area or (b) gig in Annapolis area at least 12
times per year or (c) have a demonstrated and long-term commitment to and
involvement in the Annapolis music scene.

2) You must have experienced a catastrophic event within the preceding twelve (12)
months, such as (a) a natural disaster, (b) a medical emergency or (c) a debilitating
disease or illness.

You may be required to provide financial information at the discretion of the AMFM board. 

If you qualify, complete this “Application for Catastrophic Benefits” and submit it to AMFM.

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

IF YOU ARE NOT AN ANNAPOLIS RESIDENT:
If you are not an Annapolis resident, you must list at least 12 dates and venues where you have performed in the Annapolis area in the last 12 months (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), or describe your demonstrated and long-term commitment to and involvement in the Annapolis music scene.

CATASTROPHIC BENEFIT APPLICATION FORM

Date:

Name:

Address:

City:

State:

Zip:

Home Phone:

Mobile Phone:

Email:

Name of your Band:

Instrument(s) played professionally:

IF YOU ARE NOT AN ANNAPOLIS RESIDENT: If you are not an Annapolis resident, you must list at least 12 dates and venues where you have performed in Annapolis in the last 12 months (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), or describe your demonstrated and long-term commitment to and involvement in the Annapolis music scene.

IF YOU ARE NOT AN ANNAPOLIS RESIDENT, enter 12 performances in the past 12 months in the box below:

In this box, please enter the following information: Date/Venue/Name of Band For example, multiple entries will look like this: 01/01/12 – Joe’s Tavern– My Band’s Name 02/01/12 – Bob’s Bar – My Band’s Name

In the box below, please explain your situation in 250 words or less, including how the catastrophic event that you have experienced has affected you financially:

Essay of Your Situation:

IMPORTANT: Please be sure you have completed all fields with necessary information including the essay of your situation (250 words or less). Incomplete applications will not be processed.

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