APPLICATION FOR LOST GIG BENEFITS


Please note: In order to qualify for lost gig benefits, t
he applicant must either reside in the Annapolis area or gig in the Annapolis area at least 12 times per year. 

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 “Application for Lost Gig Benefits” and submit it to AMFM.  Applications must be submitted within 6 months of the date of the lost gig.

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

LOST GIG BENEFITS APPLICATION FORM

 

Date:
Name:
Address:
City:
State:
Zip:
Home Phone:
Mobile Phone:
Email:
Name of your Band:
Instrument(s) played professionally:
Please complete the following information for AMFM to verify gigs lost:
In the boxes below, please enter the following information: Date of Gig, Venue, Location, Band Name, Revenue Lost, Venue Contact, Venue Phone
ENTRY 1:
Date:
Venue:
Location:
Revenue Lost:
Band Name:
Venue Contact:
Venue Phone:
ENTRY 2:
Date:
Venue:
Location:
Band Name:
Revenue Lost:
Venue Contact:
Venue Phone:
ENTRY 3:
Date:
Venue:
Location:
Band Name:
Revenue Lost:
Venue Contact:
Venue Phone:
If you have lost more than three gigs, please provide that additional information in the box below:
Additional Info:
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.
IF YOU ARE NOT AN ANNAPOLIS RESIDENT, enter 12 performances from the past 12 months in the box below:
In the box below, please explain your situation in 250 words or less.
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.
Please enter the code displayed to verify you're a human.
Please enter the code displayed to verify you