Street Team

First Name:
Last Name:
E-mail:
Address:
City:
State:
Zip:
Country:
Phone:
Cell:
Fax:

What is your favorite genre?

Favorite Topshelf Records band?:

Are you in:
College
High School
Work Full-time
Let's just say I get my fair share of Jerry Springer

Access to transportation?:
Yes No

Where's your local music scene?:

Have access to a copy machine and/or free copies?:
Yes No

Are you affiliated with any record labels, zines, distros, promoters, etc.?
Yes No

If yes, Please clarify:

In a band?:
Yes No

If yes, what band?:

Do you have a radio show?:
Yes No

If yes, in what area?:

Anything else you feel is relevant?:

Finally, favorite ninja turtle (we take this into HEAVY consideration)?:
Raphael
Leonardo
Donatello
Michelangelo