Glenn Roush Entertainment
Information Request Form
Date Of Event* 
First Name* 
Last Name* 
Email Address* 
Telephone* 
Guest Count
Start Time 
End Time 
Event Location (venue)* 
(if your event location is not listed above please fill in the following...)
Event Location (venue) 
Event Location (city) 
Event Location (State) 
Type Of Event* 
Additional Questions Or Event Details 
How did you hear about us?
Will the reception be outdoors?*
Do you need sound equipment & music for the ceremony?
* required fields