First Name: Last Name: Company Name: Telephone: Email Address: Reason for Celebrity: Advertising and Publicity Campaigns Launches for Products or Services Keynote Speaking Endorsements/Face of Brand MC's/Hosts Appearances - Functions/Gala Dinners Presenters/Models – TV or Ad Campaigns Entertainment - Comedians/Bands Team Motivation Ambassadors Sports Events Special Occasions Charity Fundraisers Other details/Questions: Date Required: DD/MM/YYYY Budget Range: $0 - $2500 $2,500 - $5,000 $5,000 - $10,000 $10,000 - $20,000 $20,000 - $50,000 $50,000 + Celebrity choices: (Please list celebrity names in order of preference) 1: 2: 3: