Disc Jockey Application Form

Please provide the following contact information: (**Required fields)

Full Name**
Title**	Mr./Ms/Mrs.
DJ Name/DJ Company
Street Address**
Address (cont.)
City**
State/Province**
Zip/Postal Code**
Country**	Select a CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosniaBotswanaBrazilBulgariaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsChadChileChinaChristmas IslandColombiaComorosCongoCook IslandsCosta RicaCroatiaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalklandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandMariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSurinameSwazilandSwedenSwitzerlandTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad/TobagoTunisiaTurkeyTurkmenistanTurks/Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaViet NamVirgin Islands (British)Virgin Islands (U.S.)Western SaharaYemenZambiaZimbabwe
Cell Phone
Home Phone**
FAX
E-mail**
Your Website
Date of Birth**
Years of experience**	yrs
Brief description of equipment**
Any references you can supply**
Distance/States you travel to**
Sex**	Male Female
Do you have Liability Insurance**	Yes No

You will be contacted shortly by email;

Please email a photo of yourself to us at

aadmin@kevincolangelo.com

Copyright © 2007 Kevin Colangelo Premiere Disc Jockeys USA. All rights reserved.