ON-LINE REGISTRATION FORM

AGENT COMPLAINT FORM

If you believe your talent agent has violated the EIC Code of Ethical Conduct and/or acted in an unethical manner, please fill out this online form.

Performer First Name:

Performer Last Name:

Address:

ACTRA Member Number (if applicable):

Best Phone Number:

Email Address:

Agent Name:

Agent Address:

Agent Phone Number:

Please provide complete details of the problem or concern including date and production name:

If you have additional and/or supporting documentation, please fill out the downloadable
EIC Agent Complaint Form and submit your complaint by fax or email.