DATE:________________________ How did you hear about us?______________________________
.....................................REGISTRATION TYPE:______GENERAL _____TALENT _____REPRESENTED

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LAST NAME ........................................................FIRST NAME .....................................MIDDLE NAME

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ADDRESS ...........................................................CITY ................................STATE .._................ZIP

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EMAIL ADDRESS .................................................DATE OF BIRTH ............................

IMPORTANT: IF UNDER THE AGE OF 18, CHECK HERE IF REGISTRANT HAS AN ENTERTAINMENT LABOR CONTRACT: ___

PHONE NUMBERS: ..............................Best time to call: ____________________________________

HOME: ( ____ ) ____________.....WORK: ( ____ ) ____________.....MOBILE:( ____ ) ____________
FAX: ( ____ ) ____________.......PAGER: ( ____ ) ____________.....OTHER: ( ____ ) ____________

PHYSICAL DESCRIPTION:
Please be as accurate as possible about your physical description. Producers look for people of all sizes, ages, and colors. "Age Range Portrayed" is the range of ages that you think you could look like. For "Ethnicity Portrayed," list ethnicities you think you could be identified with.

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HEIGHT ..WEIGHT.. AGE RANGE PORTRAYED.. HAIR COLOR ..EYE COLOR.. ETHNICITY PORTRAYED

LANGUAGES SPOKEN (Fluently): ______________________________________________________________

VEHICLES & PETS:
Some producers may ask for someone with a specific vehicle or pet for certain scenes. Complete any of the spaces below which apply to you, if you would like this information to be included.

CAR:______________________________________ BOAT:___________________________________
.........YEAR .....MAKE........ MODEL .......COLOR ..................YEAR ......MAKE....... MODEL ........COLOR

MOTORCYCLE: ______________________________ PET:___________________________________
.......................YEAR ...MAKE...... MODEL .....COLOR ...........TYPE .........AGE .....BREED ........COLOR

MEASUREMENTS: (for costumes, etc.)

MEN/BOYS: _________________________________________________________________________
........................COAT........NECK/SHIRT.......SLEEVE .......WAIST...... INSEAM .......SHOE..... HAT SIZE

WOMEN/GIRLS: ______________________________________________________________________
..............................DRESS ........PANTS ........BUST ........WAIST........ HIPS .........SHOE....... HAT SIZE

PLEASE INDICATE YOUR PREFERENCE IN DOING ANY OF THE FOLLOWING:
CUT YOUR HAIR? __YES __NO NIGHT SHOOTS? (thru the night) __YES __NO
CHANGE YOUR HAIR COLOR? __YES __NO ARE THERE TIMES WHEN YOU'RE  
EXTRA WORK? __YES __NO DEFINITELY NOT AVAILABLE? __YES __NO
JOBS FOR LESS THAN $50/ DAY? __YES __NO If so, when?_____________________________
PARTIAL NUDITY (over 18 only) __YES __NO _______________________________________
FULL NUDITY (over 18 only) __YES __NO Anything else? ___________________________

ARE YOU A UNION MEMBER? __YES __NO (If yes, please include your union number below)

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SAG# ................................AFTRA# ................................AEA# ................................OTHER

ARE YOU REPRESENTED BY A TALENT AGENCY? __YES __NO (If yes, please fill out information below)

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AGENT'S NAME ..........................................COMPANY ........................................AGENT'S PHONE #

SPECIAL SKILLS:
Some producers look for specific skills and abilities. Please circle the number that corresponds with your experience level in the following skills - list other areas in which you have special skills in the blank lines!......... 1 = Beginner ..|.. 2 = Intermediate ..|.. 3 = Advanced ..|
1 2 3 Aerobics 1 2 3 Gymnastics 1 2 3 Photography 1 2 3 Stick Shift
1 2 3 Archery 1 2 3 Hackey-Sack 1 2 3 Pilot a Plane 1 2 3 Stripper
1 2 3 Astrology 1 2 3 Hand Model 1 2 3 Pool Player 1 2 3 Surfing
1 2 3 Ballet 1 2 3 Handball 1 2 3 Precision Driving 1 2 3 Swimming
1 2 3 Ballroom Dance 1 2 3 Hang Gliding 1 2 3 Psychic 1 2 3 Tap Dance
1 2 3 Baseball 1 2 3 Hip Hop 1 2 3 Racquetball 1 2 3 Tennis
1 2 3 Basketball 1 2 3 Horseback 1 2 3 Rock Climbing 1 2 3 Track
1 2 3 Bicycling 1 2 3 Ice Hockey 1 2 3 Rodeo Person 1 2 3 Trampoline
1 2 3 Body Surfing 1 2 3 Ice Skating 1 2 3 Roller Blade 1 2 3 Ventriloquist
1 2 3 Bowling 1 2 3 Irish Step 1 2 3 Roller Skate 1 2 3 Volleyball
1 2 3 Boxing 1 2 3 Jazz Dance 1 2 3 Rowing 1 2 3 Walk on Stilts
1 2 3 Canoeing 1 2 3 Juggling 1 2 3 Rugby 1 2 3 Water Polo
1 2 3 Chef 1 2 3 Leg Model 1 2 3 Sailing 1 2 3 Water Skiing
1 2 3 Clown 1 2 3 Magician 1 2 3 Salsa Dancing 1 2 3 Weight Lifting
1 2 3 Comedian 1 2 3 Martial Arts 1 2 3 Scuba Diving 1 2 3 Whistling
1 2 3 Disc Jockey 1 2 3 Masseuse 1 2 3 Sign Language 1 2 3 Windsurfing
1 2 3 Driving 1 2 3 Mid. Eastern Dance 1 2 3 Singer 1 2 3 Wrestling
1 2 3 Driving a Boat 1 2 3 Mime 1 2 3 Skateboarding 1 2 3 ____________
1 2 3 Fencing 1 2 3 Model 1 2 3 Skydiving 1 2 3 ____________
1 2 3 Figure Skating 1 2 3 Modern Dance 1 2 3 Snorkeling 1 2 3 ____________
1 2 3 Football 1 2 3 Motor-Cross 1 2 3 Snowboarding 1 2 3 ____________
1 2 3 Foot Model 1 2 3 Motorcycling 1 2 3 Snow Skiing 1 2 3 ____________
1 2 3 General Contractor 1 2 3 Mountain Bike 1 2 3 Soccer 1 2 3 ____________
1 2 3 Golf 1 2 3 Mountain Climbing 1 2 3 Softball 1 2 3 ____________

APPEARANCE:
Some producers look for a specific appearance or set of features. Please check the box next to the appearance(s) you can portray. Check all that are applicable. These must be appearances that you have now (i.e.: since you can't grow a beard in one day, DO NOT check "facial hair" unless you have it now). Sometimes roles must be filled on a very short notice.
___BALD ___DENTURES ___LARGE EARS ___TATTOOS
___BIG EYES ___DISABLED ___LARGE NOSE ___TOUPEE
___BIKER ___DREADLOCKS ___LEFT HANDED ___TWIN
___BODY BUILDER ___EXTRA LONG HAIR ___LITTLE PERSON _________________
___BODY PIERCINGS ___FACIAL HAIR ___PUNKER _________________
___BUSINESS EXEC. ___FRECKLES ___RECEDING HAIRLINE _________________
___CURLY HAIR ___LARGE BUILD ___SCARS _________________
I authorize North Coast Casting and its agents to release any information contained on both pages of this registration form, or any information or photographs subsequently obtained, to any producer, director, or studio executive for the purpose of talent casting. I hold North Coast Casting, its employees, and its agents free from any liability incurred as a result of the release of this information. I further authorize North Coast Casting to use my name, photograph, and likeness on its web site.
  ____________________________________________________________ ______________________________
  Signature of Registrant Date
  ____________________________________________________________ ______________________________
  Signature of Parent or Guardian of Registrant under the Age of 18 Date
NOTES: (North Coast Casting Use Only)
The design and content of this registration form may not be duplicated or used without permission. Copyright North Coast Casting, © 2002

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