12th DIMF MusicalStar Sign up Form —

12th DIMF MusicalStar

Sign up Form —— Asia region
Nationality*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry you from
Legal Name*

First NameLast Name
Preferred Name (If applicable)

First NameLast Name
Date of Birth*

DayMonthYear
born after JAN 1, 2002 & before DEC 31, 2017
Gender*

MaleFemalePrefer not to sayOther
Education status*

In schoolGraduateno Education ExperienceOther
Educational Background*

School Name

Major

GradeState / Province

State
Phone Number*

Country CodeArea CodePhone Number
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Headshot Photo*

Accepted file formats: JPG/JPEG/PNG, with a file size not exceeding 10 MB
Cancelof
Authenticity Commitment*

I confirm that the information on this application is true and I apply for the 12th DIMF MusicalStar.
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