First Name MI Last Name

DJ Nickname

Address:

City:State: Zip:

Home Phone: Work Phone:
Cell Phone:   2-Way:
Pager#:      Email Address:

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CLUB OR MOBILE INFORMATION

Club/Company Name:
Business Address:
City:
State:
Zip Code:
Phone#:
Fax#:
Owner's Name:
Manager's Name:

    Select The Nights You Work:

Sun	Mon	Tues	Wed	Thurs	Fri	Sat
Yes No	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No

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Club/Mobile Equipment

Does Club Have CD Player?: Yes No     Pitch Control?: Yes No

Does Club Use Videos?: Yes No VHS Beta U-matic

Number of Sound Systems in Club or Company?: 1 2 3 4 5 6 7 8 9 10+

If Mobile, Number of shows per month?: 1 2 3 4 5 6 7 8 9 10+

Do You Use Contracts?:  Yes No

Number of DJ's in Your Club/Company NOT in Pool?: 1 2 3 4 5 6 7 8 9 10+   

    I am interested in

Dance Vinyl Service	Urban Vinyl Service	CD Only Service	Urban CD Series	Dance CD Series	Underground CD Series	Pool/NET CD Series
Yes No	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No