First Name
  | 
			
				* Required
  			 | 
		
			Last Name
  | 
			
				* Required
  			 | 
		
		
		    Sex
  | 
		    
		      * Required
 
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			Date Of Birth
  | 
			
				* Required
  			 | 
		
			Stage Name Choice #1 - Must be a real sounding first and last name
  | 
			
				* Required
  			 | 
		
			Stage Name Choice #2 - Must be a real sounding first and last name
  | 
			
				* Required
  			 | 
		
		
			| Email Address | 
			
				* Required
  			 | 
		
		
			| Phone Number | 
			
				* Required
  			 | 
		
		  
			| State or Providence | 
			
* Required
  
			 | 			
		
		
			
		
			| Country | 
			
				
				* Required
  			 | 
		
		    Computer Type:
  | 
		    
		      * Required
 
  | 
		    
		
		
			| How did you hear about us? | 
			 * Required
 
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