Please use the form below to request a Heart-Lites show for your organization or to submit comments or questions.

To contact the Heart-Lites directly, please email Annette Hallock at annettehallock@hotmail.com or by clicking here ==> EMAIL

Contact Information

  Contact Name:
  Email Address: Phone:
  Organization:
  Does this group specifically support Altzheimer's research, patients or caregivers?
    Yes No  

Performance Request

Performance Date:
Alternate Dates:
Audience Size: (approximate OK!)
Location:
Does this venue have the following items available for use in the performance?
  Piano  
Yes
No    
  P/A System  
No    
Show Requested: (Please note: Not all shows are available at all times)
  First Choice:
  Second Choice:

Questions or Comments: