First Name:
Last Name:
Age:
Email:
Street Address:
Apt. or Floor:
City:
State: Select ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING
ZIP:
Country:
(Note: must be a resident of the US or Canada to receive stickers, be eligible for contests, or other mailed dispatches from the Primordial Army. We regret that we cannot support other international members this way at this time.)
How have you promoted Primordial Music? (Select any / all that apply) - Not all are required!
Contributed a donation of: $
(All donations are helpful, but a donation of $15 or more will guarantee membership for 1 full year.)
Posted web banners on my home page, myspace page, etc.
The address of my web page, myspace page, or other social networking site page(s):
Emailed, sent messages or bulletins about Primordial Music or a specific Primordial album
Tell us about it:
Printed and hung up posters / distributed passes at the following location(s):
Requested Primordial Music artists to be played on these radio or podcast shows:
Purchased Merch from the Primordial Music store. What did you buy?
What other ways have you helped promote Primordial Music?
Do you have any other ideas for how you can help promote Primordial Music?
©2007 Primordial Music contact@primordialmusic.com