MPO Jaws Musician Payment

As a performer Jaws in Concert, Massapequa Philharmonic will be paying you $400. MPO has informed me that checks will sent through the mail after the orchestra receives and processes the payment from Tilles Center. Checks will be sent via postal mail.

It is important that we have the correct information for payment, including your correctly spelled name and your postal address.

Please fill out this form as soon as you can so we have this information ready.

Name

First Name

Last Name

Payee for Check (if different than name)

Email

Address for Check Payment

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Instrument

Please provide your instrument