| First
Name: |
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| Last
Name: |
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| E-Mail:
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| Address: |
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| City: |
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| State/Province: |
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| Zip
Code/Postal Code: |
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| Country: |
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| Phone: |
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| Age: |
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| How
you would like to contribute to Big Sound |
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| What
3 clubs in your area would you like to introduce D'Breeon's
Music to so that a show can be set up?: |
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| What
3 radio stations in your area would you like to visit / request
D'Breeon's Music? |
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| What
record store in your area would you like to visit / request
D'Breeon's Music? |
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How
often do you
go to shows? |
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Your
five favorite
entertainment web sites: |
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How
long have you
been surfing the Net? |
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| Are
you in school or college? |
yes
no |
| If
yes, what level are you? |
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| Are
you involved with any campus organizations/clubs? |
yes
no |
| If
yes, please list: |
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| Do
you have a car? |
yes
no |
When
is best to
reach you by phone? |
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Why would you like to be a rep for BIG SOUND Records?
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Please list your job experience.
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Thank you!
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