Membership Application Form

   **2011/12 financial year membership only $30**
Please fill in all fields marked with a * 
Name of Act * Please fill in
Brief Description (eg. Singer/Songwriter or 5 Peice Rock Band)
Company if applicable
Email * Please fill in
Twitter
Website
Phone (eg. 02 1234 1234)
Location (eg. Sydney)           State 
Category 1 * Please select one
Category 2 (Optional)
Category 3 (Optional)
Upload Photo (JPG, JPEG, BMP or GIF files only)

Other Details or Comments