Team to Join Road CrewE-Team A&R Team

           First Name:              Last Name:

                    Email:  

             Password:   

                Birthday: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1960 1961 1962 1963 1964 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

     Street Address:      Apt/Bldg/Suite #:

                       City:                        State:

                         Zip:        Phone Number:

Do You Have Transportation:Yes No      What Major City are you Near:

What Band are you signing up for:    HotDog MZLead PWC UnMask

What are your Favorite Bands:                                             What are your least Favorite Bands:
                                

What are your Favorite Radio Stations               Is there anything else we should know about you