Full Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

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Tattoo Style *

Just a Pop-Uh Color

Strictly Black & Grey

Availability *

I have a flexible schedule

I have limited availability (If selected please provide range of dates below)

Which studio are you booking for? *

Please Select One

Proxima Artistry Collective (Kingston, PA)

Black Royale Tattoo Studio (Endicott, NY)

Convention (If selected please specify which show & day below)

How did you hear about my work? *

Word of Mouth

Facebook

Instagram

Saw a random in public and asked about their work

Please verify that you are 18 years or older *

Yes, I have travelled around the sun at least 18 times.