CMT/NSAI SONG CONTEST ENTRY FORM

Print & mail completed form to NSAI with your song(s), lyric sheet(s) and payment. You may enter as many times as you wish; however, the entry form only provides room for two songs. You may print out or copy additional entry forms to enter additional songs.


Name: ________________________________________________________ Age: _______

Address: __________________________________________________________________

City/State/Postal Code:_______________________________________________________

Province/Country: ___________________________________________________________

Phone: _________________________ E-mail: ____________________________________


Song Title: _________________________________________________________________

Song Title (if entering two songs): _______________________________________________

Are you a current NSAI member? (You do not have to be a member to enter nor will your answer in any way affect judging.)   Yes [  ]   No[  ]

REQUIRED: How did you hear about the CMT/CMT.com NSAI Song Contest?

[  ] Through the Mail

[  ] Received Email

[  ] Magazine/Newspaper, please list publication: ______________________________

[  ] Internet, I saw it at www.______________________________.com

[  ] Radio, I heard it on ______________________________

[  ] TV, I saw it on ______________________________

[  ] Other: ______________________________


REMEMBER TO INCLUDE LYRIC SHEET(S) TYPED OR PRINTED LEGIBLY!
EACH SONG ENTERED MUST BE ON A SEPARATE CD OR TAPE.

$40 for one song if received on or before September 30, 2004
$55 for two songs if received on or before September 30, 2004
$45 for one song if received on or after October 1, 2004
$60 for two songs if received on or after October 1, 2004

**CURRENT NSAI MEMBERS RECEIVE A $5 DISCOUNT ON ENTRY FEE.

ALL ENTRIES MUST BE POSTMARKED BY NOVEMBER 30, 2004

If paying by credit card, circle one:       VISA         American Express         MasterCard

Card #: ________________________________________ Expiration date: ______________

Name on card: ___________________________ Signature: __________________________


If paying by check or money order, make payable (U.S. funds only) to: NSAI

Mail entries to:
NSAI -- "ATTN: SONG CONTEST"
1701 West End Avenue, 3rd Floor
Nashville, TN 37203


I have read and understand the rules of the CMT/NSAI Song Contest as they appear in the Rules and Regulations section on this website, and I accept the terms and conditions of participation. (If entrant is under 18 years old, the signature of a parent or guardian is required.)

Signature: _________________________________________ Date: __________________