subject_line
Independent Artist Registration Form
Independent Artist Form
Name
*
Email Address
*
Address
*
City
*
State
*
Zip
*
Phone
*
Band Name
*
Album Name
*
Do you understand 101.6 the mix don't have set times or dates your songs will be played
*
Yes
No
Do you agree to let all of 101.6 the mix disk jockeys play your song or songs
*
Yes
No
Did you send files to 1016themix@gmail.com
*
Yes
No
Signature
*
clear
Date
*
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