HomeBase Promotions - Online promotions for Independent artists, models, parties, events

E-TEAM / STREET TEAM SIGN-UP FORM

Please fill in the fields below. All fields are required unless otherwise indicated.

NOTE: All Street Team promoters must have a Myspace profile from which they can promote. Please DO NOT apply if you do not have a Myspace profile.

Your application will be automatically approved unless we notify you otherwise.

	First Name*
	Last Name*
	Address*
	City*
	State*
	Zip Code*
	Gender*
	Birthdate (MM-DD-YYYY)*
	E-mail Address*
	Cell Phone# (XXX-XXX-XXXX)*
	How often do you check your email?*
	Occupation*
	Indicate College Attended (if applicable)
	College Major (if applicable)
	Best time to contact you*
	How did you hear about us?*
	Which Team are you joining? (NOTE: All Street Team members are also required to promote on Myspace)*		G
	Myspace URL*
	Why do you want to join the Street Team?*
	Describe current affiliations with other promotional companies (if any)
	Areas of Interest (check all that apply)*		Artist/Performance Reviews Blogs and Forums Contests DJ (Mixtapes, Internet Radio) Event Reviews Event Sponsorships Facebook Promotions Fundraisers MySpace Promotions Photography Production Assistant Radio Show Co-host Street Level Promotions Team Strategy/Leadership
	Shirt Size*
	Street Team Nickname*
	Acknowledge Terms and Conditions*		I have read and understand the Terms and Conditions
	Verification code*

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