Musicians Registration

All fields marked with a red * are required.
First Name: *
Middle Initial:
Last Name: *
Address: *
City: *
State/Zip: *
Telephone: * (XXX) XXX-XXXX format
Work Telephone:
Fax:
Cell Phone:
E-Mail: *
Web site:http://
Please enter your web site address (e.g., www.dcjazz.com)
What is your main instrument:
What additional instruments do you play:

Hold the control key to select more than one
Other music-related business or occupation:
What is your main style:
Additional styles?:

Hold the control key to select more than one
What equipment do you have:
Steady Gigs:
Availability:
Union:
Type of Group or Band:
Size of Group or Band:
Acoustic or Electric:
Group or Band Name:
Travel or Touring:
Teacher:Yes No
Demo Available:Yes No
Type of Demo:Cassette CD
Press Kit:Yes No
Do you play?:
Hold the control key to select more than one
Additional Comments and
Biographical Information:

Please select a username and password for access to Cyber-Union:

Username: *
Password: *
Type Password Again: *