Please provide the following info:

Your Name
Age
Date of birth
City
State
Parent's Daytime or Cell Phone
Your E-mail
Band Name (if applicable)
You or your band's website

          You will be competing as a:

Individual Singer

Singing group or Band                  How many members are in your band? 

Names of band members & ages
(NOTE: If you are submitting a band for consideration, at least 50% of the members of your band MUST be under 18 years old):

What style of music do you perform? (Rock, Pop, Country, Christian Contemporary, etc.) 

Tell us how you or your band got started:

 

What is the You Tube Video or My Space Video URL address where your video can be found:
Example: www.youtube.com/watch?v...

Name of your song?

How did you hear about the contest:

TV News	Which station:
AM Radio	Which station:
FM Radio	Which station:
Newspaper	Which paper:
Internet	Which website:
Other	What other:

 

Please include any additional information in the box below:

By clicking on the "Submit" Button below, I confirm that I am granting permission for my image and/or my music to be played
on "The Radio Cafe" radio show and to be posted on The Radio Cafe website, and that the music that I am submitting is an original work created by me
and that I/my band have never recorded my/our own cd.