EmailMe Form - Submit Your Best Song

First Name *

Last Name *

Producer (First & Last Name)

Label *

Label Website

Street Address *

City *

State *

Zip Code *

Phone *

Cell Phone

Email Address *

Track/Song Title *

Add Track Title

Album Title

Format/Genre *

Do you have a UPC Bar Code for this song? *

Yes

No

If you have a bar code for this song, please add it here.

Copyright Date *

MM / DD / YYYY

Official Release Date *

MM / DD / YYYY

Artist(s)/Group Name *

Artist(s)/Group Website

Writer(s)/Composer(s)

Description/Requirements

Duration *

For example: 00:00 Song must be less then 6:00 minutes.

File Upload - upload your mp3 here. *

I confirm that this is my song and I own the rights to it. I also confirm that all the above information is accurate, correct and complete. *

Yes

I am also submitting my first payment of $499.00 to begin my Best Song submission to radio. My credit/debit card will be automatically charged via PayPal for the second month in thirty days. *

Yes