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* 1. Name

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* 2. Contact Email

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* 3. Contact Number 

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* 4. What Southwest town are you from?

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* 5. Postcode

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* 6. Genre

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* 7. Please provide a short bio about yourself (100 words max)

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* 8. Would you like to receive WAMplifier - WAM's free fortnightly eNews?

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* 9. Would you like your act to be considered for a performance slot at Across the Road Festival?

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