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2. Band or Performer Name (as it will be advertised)*
4. Short bio of your band / yourself (including genre) that we will use to advertise*
6. Links to your music or videos we may use to advertise*
8. Main Contact Name*
9. Email*
11. Mailing Address - This is where we will mail your payment*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
19. Are you performing solo or with band mates?*

    1. Solo
    2. With band mates
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field