TALENTS INC

TALENTS INC. 10204 Ebb Tide Ln. Laurel, MD 20723		TEL: 301 490 8854 FAX: 301 490 8226 E-MAIL: INQUIRIES@TALENTSINC.COM URL: WWW.TALENTSINC.COM

		Personal Information
	First name	*
	Last name	*
	Job title	*
		Contact Information
	Company name	*
	Address	*
	Suite \ P.O . Box
	City	*
	State	*
	Zip code	*
	Day phone	*
	Day fax
	Email	*
		Emergency Contact Information
	Promotion ID
	Specific Needs
	Name
	* REQUIRED