Request for Moulage Artists

Request for Moulage Artists

North Central Texas Council of Governments

Your name*

Your Cell Phone*

Phone

Your Email*

Organization Name*

Event Name*

Event Type*

(MCI, Active Shooter, Disaster, CERT Drill, etc.)

Event Date*

Event Location*

Include address, room location for moulage, and parking info

Start Time for Moulage Artists*

End Time for Moulage Artists*

Number of Moulage Artist Needed*

Number of Actors needing Moulage*

Type of Wounds*

Gun shot wounds, burns, lacerations, fractures, impalement, etc.

Are Moulage Supplies Provided by Entity?*

NCTCOG supplies are available upon request, but limited

Can artist bring additional supplies*

Select or enter value

Event Point of Contact Name*

Event Point of Contact Email*

Event Point of Contact Phone*

Phone

Are there any security issues?

Send me a copy of my responses

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