Adult Production Health & Safety Services

Performer Pre-Registration Application

By submitting this form, you will be pre-registered in the APHSS Database. You will receive an e-mail with further instructions when the APHSS Database is ready for access.

* Exactly as it appears on your official ID.

*First Name:
*Middle Name:
*Last Name:
Email:
Phone:

For more information about the APHSS Database, visit the Free Speech Coalition website: FreeSpeechCoalition.com

FREE SPEECH COALITION
P.O. Box 10480
Canoga Park, CA 91309
Phone: (818) 348-9373
Fax: (818) 348-8893
Diane Duke — Executive Director: diane@freespeechcoalition.com
Joanne Cachapero — Membership Director: joanne@freespeechcoalition.com
Membership Services: membership@freespeechcoalition.com
Media Inquiries: info@freespeechcoalition.com

APHSS Database and Producer / Agent Registration Forms Coming Soon.

Check back with this site after June 3, 2011. Thank you.

© 2011 Free Speech Coalition