If you are a musician between the ages of 13 and 18, you can win a free trip to the world renowned Power Chord Academy!

Just fill out the form below, and you will be eligible to win the opportunity of a lifetime!

	First Name: Last Name: Email: Age: -- select -- 13 14 15 16 17 18 Over 18 Address: City: State: -- select -- OTHER STATE 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 OTHER STATE ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND NORTHWEST TERRITORIES NOVA SCOTIA ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORY Other State: Zip: Country: -- select -- USA Canada U.A.E Brunei Darussalam Bolivia Brazil Bahamas Bhutan Bouvet Island Botswana Belarus Belize Congo Switzerland Chile Cameroon China Colombia Costa Rica Cuba Cape Verde Christmas Island Cyprus Czech Republic Germany Denmark Dominica Algeria Ecuador Estonia Egypt Ethiopia Finland Fiji France Gabon United Kingdom Grenada Georgia French Guiana Ghana Gibraltar Greenland Gambia Guinea Guadeloupe Greece Guatemala Guam Guyana Hong Kong Honduras Croatia Haiti Hungary Indonesia Ireland Israel India IranIceland Italy Jamaica Jordan Japan Kenya Kyrgyzstan Cambodia Kiribati Comoros North Korea South Korea Kuwait Kazakhstan Lebanon Saint Lucia Liechtenstein Sri Lanka Liberia Lesotho Lithuania Luxembourg Latvia Morocco Monaco Madagascar Mali Myanmar Mongolia Macau Martinique Mauritania Montserrat Malta Mauritius Maldives Malawi Mexico BeninMalaysia Mozambique Namibia New Caledonia Niger Nigeria Nicaragua Netherlands Norway Nepal Nauru Niue New Zealand Oman Panama Peru Philippines Pakistan Poland Pitcairn Puerto Rico Portugal Palau Paraguay Qatar Reunion Romania Russian Federation Rwanda Saudi Arabia Seychelles Sudan Sweden Singapore St. Helena Slovenia Slovakia Senegal Somalia Spain Suriname El Salvador Swaziland Thailand Tajikistan Tokelau Turkmenistan Tunisia Tonga Turkey Trinidad and Tobago Tuvalu Taiwan Tanzania Ukraine Uganda Uruguay Uzbekistan Vatican City Venezuela Viet Nam Vanuatu Samoa Yemen Yugoslavia South Africa Zambia Zaire Zimbabwe Antigua and Barbuda Anguilla Albania Armenia Netherland Angola Antartica Argentina American Samoa Austria Australia Azerbaijan Bosnia-Herzegovina Barbados Bangladesh Belgium Burkina Faso Bulgaria Bahrain Burundi Benin Bermuda Grade: -- select -- 5 6 7 8 9 10 11 12 Out of High School Experience: -- select -- Less than 1 year 1 years 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years + How Did You Hear About Us? -- select -- I'm a Past Attendant Web - Online Ad (Please list below) Web - Other (Please list below) A Summer Camp Website Search Engine - Google Search Engine - Yahoo Search Engine - Other A Friend's Recommendation TV Email Magazine Newspaper Radio Other - (Please list below) Instrument: -- select -- Backing Vocalist Bassist Brass DJ Drummer Electronics Keyboard/ Piano Lead Guitarist Lead Vocalist Other Instrument Rhythm Guitarist Strings Woodwinds Do You Play Another Instrument? None Backing Vocalist Bassist Brass DJ Drummer Electronics Keyboard/ Piano Lead Guitarist Lead Vocalist Other Instrument Rhythm Guitarist Strings Woodwinds Do You Sing? -- select -- Lead Backing Lead And Backing No Music Style: -- select -- Acoustic Blues Brit Pop Classic Rock Classical Country Electronic Emo Folk Funk Fusion Grunge Hard Rock Hardcore Hip-Hop Indie Industrial Garage Rock N Roll Goth Metal New Age New Wave Power Pop Punk Reggae Jazz Rock Pop R&B Ska Favorite Bands/Artists:     Favorite Websites:     Mobile Phone: ( ) - Mobile Carrier: -- select -- AT&T Verizon T-Mobile Sprint US Cellular Virgin Mobile Boost Mobile Metro PCS TracFone Qwest Cricket Helio Other Follow Up Call? I would like to receive a follow up call from Power Chord If you are a winner, enter the email addresses of some friends who might like to come along with you! Friend 1 Email: Friend 2 Email: Friend 3 Email: