Registration Form

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Please complete all entries in the form below
make sure all spelling is correct so we have the right name, address, and e-mail

your postal address

Street / Postal Route / P.O. Box
City / Town      Province / State
Postal Code / ZIP         Country

Please type in your correct e-mail address
make sure it is correct or our e-mail will not reach you

send e-mail to

Please answer this little survey it could help us a lot

mark all boxes that apply to you

Where do you play music mark all that apply	What is your age group	How long have you been playing music
only at home in public Member of a band or orchestra Professional musician Teaching music Songwriter/Composer Member of a copyright assosiation	age under 16 age 16 -30 age 31-50 age 50 -65 age over 65	under 1 year 1-4 years 5-10years 10-25years over 25 years

Did you ever fill out a list of your music performances for a performing right agency ?

never
sometimes(10%) occasionally (15-25%)
about( 30-45% ) 50/50 mostly (75%)
always

Could you name the performance right agency

Please select the payment option
you will use for your contribution

if you have comments to go with your registration type them in here

Please double check your entries
there is no return form
make sure your e-mail address is correct
registrations with e-mail entries the mailer cannot reach are automatically deleted.

Everything is O.K.
I have double checked it
press once only

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