Name

First Name

Last Name

Phone

(###)

###

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In your own words, what are you interested in getting tattooed and why?

List 3-4 nouns you would like to incorporate into your tattoo

Placement of the tattoo

Are you interested in booking

Half Day Session

Full Day Session

Multiple Day Session

Instagram/Facebook

Are you local? Are you interested in getting tattooed at a convention? If so, which convention?