CLOWN REQUEST FORM

Dear Potentate / Clown Unit:
The services of the Aleppo Temple Shrine Clowns are respectfully requested for the following    services:          

Comments: _____________________________________________________________________________

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Client Contact: Name: _____________________   Home Phone: _______________________

Address: _________________________________     Work Phone:   _____________________

City, State, Zip: ________________________     E-Mail:   ______________________________

Job Start & End Times: ____________________________  Date: ________________________

Directions: _____________________________________________________________________________

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Number of Clowns requested: ______________   Donation Amount: $  ____________________

The Aleppo Temple Shrine Clowns are available, by completing this form and submitting it to the Potentate of Aleppo Temple for his approval, on a first-come, first-served basis.  All requests should be submitted at least  “60 days prior”  to the event.  Fees are not charged but donations are cheerfully accepted.

The Aleppo Temple Shrine Clowns have never charged any fees for their appearances.  Our clowns are trained at Clown Colleges and many of our clowns are talented, award winning individuals.  They have joined the ranks of the Shrine Clowns for the following reasons:

“For Kids of All Ages Everywhere”

(FOR CLOWN UNIT USE ONLY )
Equipment needed to cover the event:

Other: (specify) _____________________________________________________________________________

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  Boss Clown     Ring Master       Secretary          Treasurer

_______________         Terms and Conditions Sent

_______________         Acknowledgement to Requestor

_______________         Thank You Letter Sent

_______________         Monies Received           Receipt # ____________      Date: __________

_______________         How many clowns attended ______

Remarks:  _____________________________________________________________________

Date:         ____________________