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Hampton Coliseum
Application for Lease

In order that we may have completed information on file if your organization becomes a lessee of the HAMPTON COLISEUM, each applicant is required to fill out this form completely.

THIS DOCUMENT IS AN APPLICATION ONLY AND DOES NOT BIND THE HAMPTON COLISEUM; THIS IS NOT A CONTRACT FOR SPACE OR DATES.

The applicant agrees that no information about any proposed event will be made public unless a formal contractual lease agreement for same has been executed.

A minimum of ninety (90) days must be allowed for processing this application. Only after it is accepted will the Hampton Coliseum enter into a discussion of possible available dates.

Organization Name:

Trading As:

Address:

City:

State:

Zip Code:

Phone Number:

Application Status: (check one):

Corporation: Partnership: Individual:

In what County or City and State is applicant registered or incorporated?

If other than, Virginia, is your organization registered with the Virginia State Corporation Commission and licensed to do business in Virginia?
Yes No

Names and Titles of Officers or Partners:

Name of Registered Agent:

Address of Registered Agent:

Financial References: Attach financial statement to this application.

Bank: Address:	Phone#: Account#:

Bank: Address:	Phone#: Account#:

Other:	Address:

Business References: (List major facilities in which your organization has promoted events.)

Facility / Location / Contact Person / Phone Number

If you anticipate promoting concerts, list representative acts which you have promoted and agent information.

Acts Promoted / Agency Name & Address / Agent's Name & Phone

Please attach additional information which you feel will assist us in our evaluation of your application.

The undersigned certify the above information is correct based upon personal knowledge, information and belief.

Applicant:
(Organization Name)

By:
(Please print or type)

Signature:

Title: Date Filed:

If partnership, all general partners must sign below.

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Hampton Coliseum!

Hampton Jazz Festival
Tickets On Sale Saturday, March 20

BUY TICKETS NOW!

PURCHASE TICKETS BY PHONE

National Toll Free SALES:	800.745.3000
Hearing Impaired Customers Only:	800.943.4327

COLISEUM BOX OFFICE HOURS

10:00AM - 5:00PM, Monday - Friday

Closed Saturday and Sunday unless there is an event.

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